Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis

Bus, Sicco A.; Haspels, Rob; Busch-Westbroek, Tessa E.

doi:10.2337/dc10-2206

Cited by 134 publications

(202 citation statements)

References 16 publications

(23 reference statements)

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“…In terms of pressure distribution, Bus et al [17] demonstrated that peak pressure of diabetic feet was more than 600kPa in a specific MTH area; meanwhile Bus et al [18] also recommended that mean pressure 100kPa or peak pressure 200kPa shall be selected as target for pressure relieving. So in our study, we set two numbers as criterion: one is the 100% of healthy counterpart; another is the 120% of diabetic patients.…”

Section: Discussionmentioning

confidence: 99%

Classification of Diabetic Feet in Terms of Risk of Ulceration

Hu¹,

Su²,

Xu³

et al. 2017

LFJ

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ABSTRACT. Diabetic feet are common complications in diabetes mellitus, but its classification in terms of risk of ulcer based on multiple measures was rear reported. Therefore the aim of this study was to establish a classification system for diabetic feet according to data from feet deformities, plantar pressures and peripheral neuropathy. This system comprised 13 categories with three main factors in varied levels: Feet deformities [Mild (one or without deformity), Moderate (two deformities) and Severe level (more than two deformities)], peripheral neuropathy (no, moderate and serious levels) and plantar pressure distribution (≤100%MP*; 100≤ and ≤120% MP*; more than 120% MP*, where "MP*" is the data of healthy population). Further, we conducted a case study to explain of our system, the results show that 32 patients with diabetes were divided into the following categories: 22 for I++, 8 for II+, 2 for IV+. Overall, This system can help the clinician detect the risk levels of feet and take necessary measures to prevent diabetic ulcers in feet.KEY WORDS: diabetic feet, feet ulcers, classification of diabetic feet, feet deformity, plantar pressure distribution CLASIFICAREA PICIORULUI DIABETIC ÎN FUNCŢIE DE RISCUL DE ULCERAŢIEREZUMAT. Piciorul diabetic reprezintă o complicaţie frecventă a diabetului zaharat, însă rareori s-a raportat clasificarea acestuia în ceea ce priveşte riscul de ulceraţie pe baza mai multor măsurători. Prin urmare, scopul acestui studiu a fost de a stabili un sistem de clasificare pentru piciorul diabetic, în funcţie de datele privind deformarea picioarelor, presiunea plantară şi neuropatia periferică. Acest sistem a cuprins 13 categorii cu trei factori principali pe diverse niveluri: deformări ale picioarelor [uşoare (o singură deformare sau fără deformare), moderate (două deformări) şi severe (mai mult de două deformări)], neuropatie periferică (lipsa acesteia, nivel moderat şi nivel mare) şi distribuţia presiunii plantare (≤100% MP*; 100≤ şi ≤120% MP*; peste 120% MP*, unde "MP*" reprezintă datele populaţiei sănătoase). Mai mult, s-a realizat un studiu de caz pentru a explica sistemul dezvoltat, iar rezultatele arată că 32 de pacienţi cu diabet au fost împărţiţi în următoarele categorii: 22 în categoria I++; 8 în categoria II+; 2 în categoria IV+. În ansamblu, acest sistem poate ajuta clinicianul să detecteze nivelurile de risc ale picioarelor şi să ia măsurile necesare pentru prevenirea ulceraţiilor asociate cu piciorul diabetic.CUVINTE CHEIE: picior diabetic, ulceraţii la nivelul picioarelor, clasificarea piciorului diabetic, deformarea picioarelor, distribuţia presiunii plantare CLASSIFICATION DES PIEDS DIABÉTIQUES SELON LE RISQUE D'ULCÉRATIONRÉSUMÉ. Le pied diabétique est une complication fréquente dans le diabète sucré, mais sa classification selon le risque d'ulcération à partir des mesures multiples a été signalée rarement. Par conséquent, l'objectif de cette étude a été d'établir un système de classification pour le pied diabétique selon les données sur les déformations des pieds, ...

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Section: Discussionmentioning

confidence: 99%

Classification of Diabetic Feet in Terms of Risk of Ulceration

Hu¹,

Su²,

Xu³

et al. 2017

LFJ

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“…Of the studied articles, 7 studies investigated the effect of footwear on plantar pressure in diabetes patients that one article was systematic review [16], 2 case control [17,18], 2 RCT [19,20] and 1 article review [7]. In one cohort study [21], the impact of sandals in reducing plantar pressure in most areas of foot was higher in comparison to shoes.…”

Section: Plantar Pressurementioning

confidence: 99%

The Effects of Various Orthotic Treatments on the Standing and Walking Performance of Diabetic Patients

Rezaeian

Karimi

2017

PTJ

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Purpose: Today considering the high prevalence of diabetes and its associated pressure ulcers, also irreparable consequences such as amputation and death, the use of orthotic devices is increasing. A variety of devices have designed to prevent ulcers in the patients' feet, however other aspects of the treatment, especially the performance of these patients in standing and walking, which are their main daily activities, have not been considered in designing and use of orthotic devices. In addition, the differences between the available devices and their effects have not been described yet. Therefore the aim of this review article is to answer these issues. Methods:A comprehensive research was done in databases of PubMed, Google Scholar, and ISI Web of Knowledge. The keywords such as "diabetic neuropathy", "orthosis", "plantar pressure", "balance", "energy consumption", and "spatial-temporal parameters of gait" and their results were analyzed. The quality of articles were evaluated by Downs and Black tool.Results: After proper search, 245 English articles were found with the related keywords. Then, 184 articles were excluded because of a common title or incomplete text. Also, 25 articles were excluded from the study, because their contents did not relate highly to this study or have reasonable conclusion based on the findings of other articles. Eventually the results of 36 articles were examined and reported. Conclusion:This study has examined the various articles from randomized control trial to case report. Most studies emphasized on the reduction of plantar pressures and ulcer treatment with orthotic devices. A few studies are available on the effects of orthosis in standing balance and walking parameters. However, no study was found with regard to the effect of orthotic treatments on energy consumption in these patients. Because this topic is very important, it is suggested that future studies be focused on these issues.

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“…A good example of this can be considered the transposition in terms of the prescribing procedure described by Henderson and Lamoreux of the therapeutic footwear optimizing process for patients with diabetic neuropathy described by Sicco A. Bus and others [37]. Thus for therapeutic footwear prescribed by a specialist in physical and rehabilitation medicine the following elements can be formulated: -"medical objective": reducing the risk of ulceration,…”

Section: Practice Of Medical Devices Prescriptionmentioning

confidence: 99%

Regulations for the Prescription of Footwear as Medical Device

Petcu¹,

Roşculeţ²

2017

LFJ

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ABSTRACT. Orthopedic footwear is part of the category of medical devices used in the conservative treatment of foot and lower limbs pathomechanics. For the custom-made medical device the manufacturer has to perform the design based on the prescription of a duly qualified medical practitioner that sets the specific design characteristics of the device. Quality management standards in the field of medical devices govern the entire process (or parts thereof) from design and development to delivery and provide technical support for their implementation. In this respect, the prescription is constituted as an input, respectively an essential requirement of the design process and must be complete and unambiguous. This paper aims to analyse aspects of medical prescription as an essential requirement of the design and manufacturing process of custom-made orthopedic footwear. KEY WORDS: orthopedic footwear, medical device, prescription, quality management REGLEMENTAREA ACTIVITĂŢILOR LEGATE DE PRESCRIPŢIA ÎNCĂLŢĂMINTEI CA DISPOZITIV MEDICALREZUMAT. Încălţămintea ortopedică intră în categoria dispozitivelor medicale utilizate în tratamentul conservator al patologiilor de natură mecanică ale piciorului şi membrelor inferioare. În cazul dispozitivului medical fabricat la comandă, producătorul trebuie să realizeze proiectarea pe baza prescripţiei practicianului medical calificat în mod corespunzător prin care acesta stabileşte caracteristicile specifice de proiectare ale dispozitivului. Standardele de management al calităţii în domeniul dispozitivelor medicale definesc condiţiile de calitate care guvernează întregul proces (sau părţi ale acestuia) pornind de la proiectare şi dezvoltare până la livrare şi acordarea suportului tehnic pentru implementarea acestora. În acest sens, prescripţia medicală se constituie ca o intrare ("input"), respectiv o cerinţă esenţială a procesului de proiectare şi trebuie să fie completă şi lipsită de ambiguitate. Prezenta lucrare îşi propune să analizeze aspecte ale prescripţiei medicale ca o cerinţă esenţială a procesului de proiectare şi realizare a încălţămintei ortopedice fabricate la comandă. CUVINTE CHEIE: încălţăminte ortopedică, dispozitiv medical, prescripţie, managementul calităţii DES ACTIVITÉS RÉGLEMENTAIRES POUR LA PRESCRIPTION DES CHAUSSURES COMME DISPOSITIF MÉDICALRÉSUMÉ. Les chaussures orthopédiques entrent dans la catégorie des dispositifs médicaux utilisés dans le traitement conservateur des pathologies de nature mécanique du pied et des membres inférieurs. Dans le cas du dispositif médical fait sur mesure, le fabricant doit effectuer la conception à partir de la prescription d'un médecin dûment qualifié qui définit les caractéristiques de conception spécifiques du dispositif. Les normes pour la gestion de la qualité dans le domaine des dispositifs médicaux définissent les exigences de qualité qui régissent l'ensemble du processus (ou ses parties) à partir de la conception et du développement et jusqu'à la livraison y compris fournir un soutien technique pour la mise en oeuvre d...

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Evaluation and Optimization of Therapeutic Footwear for Neuropathic Diabetic Foot Patients Using In-Shoe Plantar Pressure Analysis

Cited by 134 publications

References 16 publications

Classification of Diabetic Feet in Terms of Risk of Ulceration

Classification of Diabetic Feet in Terms of Risk of Ulceration

The Effects of Various Orthotic Treatments on the Standing and Walking Performance of Diabetic Patients

Regulations for the Prescription of Footwear as Medical Device

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