This randomized clinical trial aims to compare the diagnostic performance, reproducibility, and agreement of several non-invasive instrumental methods for assessing plantar hyperkeratosis hardness in healthy subjects and patients with diabetes mellitus without active foot ulceration. Participants will be evaluated in a single study session using plantar pressure platform analysis, durometer measurements, ultrasound elastography, and infrared thermography. The study seeks to identify the most reliable and discriminative methods for clinical and preventive assessment of plantar hyperkeratosis, particularly in populations at risk for diabetic foot complications.
This is a randomized, controlled, cross-sectional clinical trial with two parallel groups: healthy subjects and patients with diabetes mellitus without active or recent plantar ulceration. All participants present at least one clinically identifiable plantar hyperkeratosis. Each subject undergoes a standardized assessment in a single session using four non-invasive instrumental techniques: plantar pressure platform, durometer, ultrasound elastography, and infrared thermography. The order of application of the instrumental methods is randomized. Primary outcomes include superficial hardness, tissue stiffness, plantar pressure distribution, and plantar surface temperature. Secondary outcomes include demographic, anthropometric, and clinical variables. The study aims to compare inter-group differences, method agreement, reproducibility, and discriminative capacity of each instrumental technique.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
50
Standardized, non-invasive diagnostic assessment of plantar hyperkeratosis performed in a single session, including plantar pressure analysis (pressure platform), superficial hardness measurement (durometer, Shore A scale), tissue stiffness evaluation (ultrasound elastography), and surface temperature analysis (infrared thermography).
Plantar Hyperkeratosis Surface Hardness (Shore A Scale)
Mean superficial hardness value measured using a calibrated Shore A durometer applied perpendicularly over the plantar hyperkeratosis. The average of three consecutive measurements will be analyzed.
Time frame: Baseline (day 0, single study visit)
Tissue Stiffness (Elastography)
Quantitative stiffness value obtained from ultrasound elastography within a standardized region of interest over the hyperkeratosis.
Time frame: Baseline (day 0, single study visit)
Maximum and Mean Plantar Pressure at Hyperkeratosis Site
Maximum and mean plantar pressure values (kPa) recorded using a calibrated pressure platform during static stance.
Time frame: Baseline (day 0, single study visit)
Surface Temperature of Plantar Hyperkeratosis (Infrared Thermography)
Mean and maximum surface temperature (°C) measured using standardized infrared thermography imaging.
Time frame: Baseline (day 0, single study visit)
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