The first aim of this study was to determine the effect of vibro-medical insole on pressure sensation and the second was to measure the effects of vibro-medical insole with and without random noise on plantar pressure distribution in diabetic patients with mild-to-moderate peripheral neuropathy.

Twenty patients with mild-to-moderate diabetic neuropathy were recruited in the clinical trial pre-test, post-test study. Medical insole was made for each participants and vibratory system was inserted it. Pressure sensation was evaluated before and after the 30-minute walks using the vibro-medical insole with Semmes-Weinstein Monofilaments. Peak pressure data was measured using the vibro-medical insole with and without random noise by Pedar-x system.

Pressure sensation is shown improvement using the vibro-medical insole with added random noise at heel, metatarsophalangeal heads and hallux of both feet in all participants (P<0.05). Peak pressure decreased significantly in heel, MTP_2,3, MTP_4,5 and hallux (P<0.05) and increased in midfoot (P<0.05) using the vibro-medical insole with and without random noise compared to shoe only condition. Only the peak pressure of the heel region decreased using the vibro-medical insole with random noise compared to without random noise (P=0.006).

Vibro-medical insole seems to improve pressure sensation and alter peak pressure in the diabetic patients with mild-to-moderate peripheral neuropathy. This work suggests that vibro-medical insole with added random noise can be used for daily living activities to overcome sensory loss and probably decrease the risk of ulceration in diabetic neuropathy patients.