Introduction

Intact foot plantar pressure can quietly climb after a leg amputation—especially in people with diabetes or vascular disease—raising the chances of skin breakdown and ulcers.
A 2025 scoping review pulled together 10 studies to see how the intact foot handles pressure and sensation after someone starts using a prosthesis.

Key Findings

• Pressures often go up: Most studies found higher pressure in at least one region of the intact foot (commonly the heel or forefoot).
  Some also showed higher pressure-time integral, a measure of cumulative load over each step. That matters because ulcers are driven by repeated stress, not just single peaks.
• Sensation often goes down: Light-touch testing (monofilament) frequently showed reduced sensation in the intact foot; vibratory sensation findings were mixed but trended worse than healthy peers.
  Less feeling can mean you miss early warning signs.
• Net takeaway: The intact foot isn’t “protected” by the prosthesis. If anything, it may carry more load with less feedback, increasing ulcer risk.

Why It Matters

For patients with diabetes, ulcers on the intact foot are a major reason for hospitalization and further amputation.
Catching overload and sensory loss early—and acting on it—can prevent wounds and keep people mobile.

What You Can Do

• Daily checks: Look for redness, callus, blisters, or hot spots—especially at the heel and forefoot.
• Right footwear & insoles: Use cushioned, well-fit shoes; consider metatarsal pads or textured insoles to improve feedback and offload pressure.
• Prosthetic tune-up: Ask your prosthetist to review alignment and component choices that may reduce contralateral loading.
• Smart activity: Build walking gradually; more steps = more cumulative tissue stress. Balance movement with recovery.
• Team care: Regular visits with your prosthetist/orthotist, podiatrist, and diabetes team are essential.

Conclusion

The intact foot deserves as much attention as the prosthetic side.
With proactive pressure management, sensation monitoring, and the right prosthetic setup, we can lower ulcer risk and keep you moving safely.

Reference

Kurth C, Farhan S, Leininger K, et al. Plantar Pressure and Sensation of the Intact Foot of Lower Limb Prosthesis Users With Diabetes or Vascular Insufficiency: A Scoping Review. Journal of Prosthetics and Orthotics. 2025;37:e88–e99.