The abnormal plantar pressure distribution and value play a key role in the formation of plantar calluses and diabetic foot ulcer. The prevalence of the highest pressure different distribution and its association with various factors among patients with diabetes is not well known. The study purpose was to evaluate the prevalence of different regions for the highest pressure on the sole and its association with selected factors among patients with diabetes. Medical records of nonulcer patients were retrospectively analysed. The relationship between pressure patterns on the sole obtained during a pedobarographic test as a semiquantitative assessment with colourful print analysis and neuropathy, gender, age, and BMI was searched. The most common location of the highest pressure was the central part of the forefoot. No association was found between the different highest pressure regions and age, sensory neuropathy, calluses, and foot deformities. The highest pressure on the lateral part of the foot and midfoot was observed more often in females and in patients with a BMI≥35. The prevalence of the highest pressure on the forefoot was more common in patients with a BMI<35. Conclusions. The most frequent regions of the highest pressure on the sole in patients with diabetes were the central part of the forefoot (2-3 metatarsal heads) with no simple relationship to the assessed variables other than BMI<35. Female gender and higher BMI seem to be responsible for shifting the place of the highest pressure to other places of the foot.
Background. The strategy of care for chronic diabetic complications prevention includes appropriate organization and education of healthcare professionals. Despite the availability of skilled medical staff, there is insufficient information about the feet examination in standard practice. We evaluated the personnel's compliance in the context of following the guidelines for foot examination. Materials and methods. We retrospectively analyzed 290 questionnaires from patients with diabetes mellitus (54.13% women) enclosed in the medical records from Diabetic Foot Center. Results. The mean patients' age was 63.24; 7.6% participants suffered from type 1 and 92.4 % from type 2 diabetes; 17.6% patients declared previous foot examination: 31.8% with type 1, 16.4% with type 2 diabetes and it was irrespective from: age, diabetes duration (p = 0.6 and p = 0.37 respectively) and diabetes type (p = 0.068). Conclusion. The foot examination among patients with diabetes, by medical practitioners, is very poor. Neither patient age nor duration or type of diabetes had an influence on the decision for foot examination in our study. Our study has showed that not the guidelines but inadequate foot examination by medical staff could be the main problem of the prevention of diabetic foot. We should stress and re-educate patients but also medical staff about the foot examination.
BACKGROUND: Injuries are the cause of professional and social deactivation. The rehabilitation program provided under Social Security prevention pension enables earlier rehabilitations measures. OBJECTIVE: The study aim was to determine the efficiency of the rehabilitation as a part of Social Security prevention pension in the group of patients after limb injuries depending on the time when rehabilitation was undertaken. METHODS: The study was a retrospective data analysis, based on medical history of 93 patients after injuries, rehabilitated as the part of Social Security prevention pension from January 2016 until July 2017. The effects of rehabilitation were assessed in 2 groups: early (up to 6 months from the injury) and late rehabilitation (over 6 months). Medical effects based on measurements of the motion range in extremities joints, functional tests results and final evaluation of the rehabilitation. RESULTS: For both groups the motion range of most joints improved. Improvement among the group of early rehabilitated patients concerned everyday activities (p = 0.035), the results of medical rehabilitation (p = 0.046) and also the results of the functional tests. CONCLUSION: Comprehensive rehabilitation of patients after the injuries in Social Security prevention pension leads to better medical effects. The results are better for earlier rehabilitated patients.
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