Pressure‐reduction and preservation in custom‐made footwear of patients with diabetes and a history of plantar ulceration

Waaijman, Roelof; Arts, Mark P.; Haspels, Rob; Busch-Westbroek, Tessa E.; Nollet, Frans; Bus, Sicco A.

doi:10.1111/j.1464-5491.2012.03700.x

Cited by 58 publications

(121 citation statements)

References 25 publications

(34 reference statements)

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…Elevated plantar pressures and ill-fitting footwear are important risk factors of ulceration (2,3). Custom-made footwear aims to reduce ulcer risk by reducing foot pressures and providing proper fit (4–6). It is clear that to be effective in ulcer prevention, prescription footwear should be worn by the patient, in particular when being ambulant (7).…”

mentioning

confidence: 99%

Adherence to Wearing Prescription Custom-Made Footwear in Patients With Diabetes at High Risk for Plantar Foot Ulceration

et al. 2013

View full text Add to dashboard Cite

OBJECTIVEPrescription custom-made footwear can only be effective in preventing diabetic foot ulcers if worn by the patient. Particularly, the high prevalence of recurrent foot ulcers focuses the attention on adherence, for which objective data are nonexisting. We objectively assessed adherence in patients with high risk of ulcer recurrence and evaluated what determines adherence.RESEARCH DESIGN AND METHODSIn 107 patients with diabetes, neuropathy, a recently healed plantar foot ulcer, and custom-made footwear, footwear use was measured during 7 consecutive days using a shoe-worn, temperature-based monitor. Daily step count was measured simultaneously using an ankle-worn activity monitor. Patients logged time away from home. Adherence was calculated as the percentage of steps that prescription footwear was worn. Determinants of adherence were evaluated in multivariate linear regression analysis.RESULTSMean ± SD adherence was 71 ± 25%. Adherence at home was 61 ± 32%, over 3,959 ± 2,594 steps, and away from home 87 ± 26%, over 2,604 ± 2,507 steps. In 35 patients with low adherence (<60%), adherence at home was 28 ± 24%. Lower BMI, more severe foot deformity, and more appealing footwear were significantly associated with higher adherence.CONCLUSIONSThe results show that adherence to wearing custom-made footwear is insufficient, particularly at home where patients exhibit their largest walking activity. This low adherence is a major threat for reulceration. These objective findings provide directions for improvement in adherence, which could include prescribing specific off-loading footwear for indoors, and they set a reference for future comparative research on footwear adherence in diabetes.

show abstract

mentioning

confidence: 99%

Adherence to Wearing Prescription Custom-Made Footwear in Patients With Diabetes at High Risk for Plantar Foot Ulceration

et al. 2013

View full text Add to dashboard Cite

show abstract

“…The study of Bus et al [14,25] in patients with diabetic neuropathy is to our knowledge the only study investigating a comparable protocol. In that study, adaptation of therapeutic footwear resulted in an additional mean PTI reduction of 24% in all ROIs [14].…”

Section: Discussionmentioning

confidence: 97%

In-shoe plantar pressure measurements for the evaluation and adaptation of foot orthoses in patients with rheumatoid arthritis: A proof of concept study

et al. 2016

View full text Add to dashboard Cite

“…This is unfortunate, because the biomechanical effects of shoe and insole designs and their features have been widely investigated and show to be consistent . Furthermore, the clinical efficacy of some of these biomechanical footwear designs in reducing risk of ulcer recurrence has been proven .…”

Section: Introductionmentioning

confidence: 99%

State of the art design protocol for custom made footwear for people with diabetes and peripheral neuropathy

Bus

Zwaferink

Dahmen

et al. 2019

Diabetes Metabolism Res

View full text Add to dashboard Cite

Supported by evidence‐based guidelines, custom‐made footwear is often prescribed to people with diabetes who are at risk for ulceration. However, these guidelines do not specify the footwear design features, despite available scientific evidence for these features. We aimed to develop a design protocol to support custom‐made footwear prescription for people with diabetes and peripheral neuropathy. The population of interest was people with diabetes who are at moderate‐to‐high risk of developing a foot ulcer, for whom custom‐made footwear (shoes and/or insoles) can be prescribed. A group of experts from rehabilitation medicine, orthopaedic shoe technology (pedorthics) and diabetic foot research, reviewed the scientific literature and met during 12 face‐to‐face meetings to develop a footwear design algorithm and evidence‐based pressure‐relief algorithm as parts of the protocol. Consensus was reached where evidence was not available. Fourteen domains of foot pathology in combination with loss of protective sensation were specified for the footwear design algorithm and for each domain shoe‐specific and insole (orthosis)‐specific features were defined. Most insole‐related features and some shoe‐related features were evidence based, whereas most shoe‐related features were consensus based. The pressure‐relief algorithm was evidence based using recent footwear trial data and specifically targeted patients with a healed plantar foot ulcer. These footwear design and pressure‐relief algorithms are the first of their kind and should facilitate more uniform decision making in the prescription and manufacturing of adequate shoes for moderate‐to‐high‐risk patients, reducing variation in footwear provision and improving clinical outcome in the prevention of diabetic foot ulcers.

show abstract

Pressure‐reduction and preservation in custom‐made footwear of patients with diabetes and a history of plantar ulceration

Cited by 58 publications

References 25 publications

Adherence to Wearing Prescription Custom-Made Footwear in Patients With Diabetes at High Risk for Plantar Foot Ulceration

Adherence to Wearing Prescription Custom-Made Footwear in Patients With Diabetes at High Risk for Plantar Foot Ulceration

In-shoe plantar pressure measurements for the evaluation and adaptation of foot orthoses in patients with rheumatoid arthritis: A proof of concept study

State of the art design protocol for custom made footwear for people with diabetes and peripheral neuropathy

Contact Info

Product

Resources

About