Abstract
Introduction: In type 2 diabetes mellitus (T2DM), elevated cumulative plantar loading contributes to ulcer risk, especially in patients with neuropathy. Static foot posture may influence plantar load distribution, but evidence remains limited. Objective: This study aimed to examine the association between FPI-6 and PTI during walking in adults with T2DM attending outpatient services at RSUD Dr. Soetomo, Surabaya. Methods: A cross-sectional study was conducted in May–July 2025 at RSUD Dr. Soetomo, enrolling 33 adults with T2DM (no dropouts). Foot posture was assessed using the FPI-6, and plantar pressure-time integral (PTI) was recorded with an in-shoe pressure system (Pedar-X) during walking; participants completed 20 steps while cadence was maintained with a metronome. Normality testing used the Shapiro–Wilk test; correlation used Pearson when assumptions were met. Results: Most participants had neutral foot posture (right 82.4%; left 70.6%). The mean PTI was highest in the forefoot, followed by the hindfoot. Correlation between total FPI and PTI was not significant for hindfoot or forefoot (all p > 0.05). Conclusion: Static foot posture (FPI-6) was not associated with dynamic cumulative plantar loading (PTI) in this T2DM cohort. These findings support the use of a combined risk assessment strategy (neuropathy, deformity, joint motion, and dynamic plantar pressure) rather than relying on static posture alone.