Stiffness degree of ankle range of motion in diabetic patients with atypical amputation

Simón-Pérez, Eduardo; Simón-Pérez, Clarisa; Alonso-Peña, David; Pontón-Cortina, Alejandro; Chicharro‐Luna, Esther; Nova, Alfonso Martínez; Navarro‐Flores, Emmanuel

doi:10.1590/1806-9282.66.2.216

Cited by 21 publications

(18 citation statements)

References 21 publications

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“…Furthermore, Eduardo et al reported that patients with diabetes who had minor amputations had an average ankle dorsi exion angle of 9.6° [34] The mean dorsi exion angle in the reamputation group in this study was 2.6°, which was very low compared to that reported in previous studies.…”

Section: Discussioncontrasting

confidence: 76%

Reamputation in patients with diabetes-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

Imaoka¹,

Sato²,

Furukawa³

et al. 2020

Preprint

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Background：Diabetes-related foot lesions are a major cause of non-traumatic lower limb amputations and are associated with a high re-amputation rate. Lesions can cause hindrance in activities of daily living, reduce physical function, and lower a patient’s quality of life. Physical therapy is necessary to prevent these limitations. Thus far, there has been limited investigation into the re-amputation rate in patients who have undergone physical therapy. This study aimed to elucidate modifiable risk factors for re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods：This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records (to surgical and physical therapy units) stored in the electronic medical records. We examined reamputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was set at 1 year. We used Cox proportional hazards analysis to examine factors affecting the risk of reamputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent reamputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with reamputation were a requirement for hemodialysis, ankle dorsiflexion angle, and ambulation Functional Independence Measure score.Conclusions: In diabetes patients with minor amputations, requirement for hemodialysis, ankle dorsiflexion angle, and functional independence measure (FIM) ambulation were shown to be modifiable risk factors for re-amputation. This emphasizes that maintaining vascular endothelial function through lower limb muscle exercises for hemodialysis, improving ankle mobility, and off-loading walking are necessary to reduce the risk of reamputation. Patients with these risk factors should be encouraged to participate in physical therapy.

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Section: Discussioncontrasting

confidence: 76%

Reamputation in patients with diabetes-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

Imaoka¹,

Sato²,

Furukawa³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Furthermore, Eduardo et al reported that patients with diabetes who had minor amputations had an average ankle dorsi exion angle of 9.6° [34]. The mean dorsi exion angle in the re-amputation group in this study was 2.6°, which was very low compared to that reported in previous studies.…”

Section: Discussioncontrasting

confidence: 72%

Re-amputation in patients with diabetes -related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

Imaoka¹,

Sato²,

Furukawa³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background：Diabetes-related foot lesions are a major cause of non-traumatic lower limb amputations and are associated with a high re-amputation rate. Lesions can cause hindrance in activities of daily living, reduce physical function, and lower a patient’s quality of life. Physical therapy is necessary to prevent these limitations. Thus far, there has been limited investigation into the re-amputation rate in patients who have undergone physical therapy. This study aimed to elucidate modifiable risk factors for re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods：This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records to surgical and physical therapy units stored in the electronic medical records. We examined re-amputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was set at 1 year. We used Cox proportional hazards analysis to examine factors affecting the risk of re-amputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent re-amputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with re-amputation were a requirement for hemodialysis, ankle dorsiflexion angle, and the Functional Independence Measure (FIM) ambulation score.Conclusions: In diabetes patients with minor amputations, a requirement for hemodialysis, ankle dorsiflexion angle, and the FIM ambulation score were shown to be modifiable risk factors for re-amputation. This emphasizes that maintaining vascular endothelial function through lower limb muscle exercises for hemodialysis, improving ankle mobility, and relieving plantar pressure during walking are necessary to reduce the risk of re-amputation. Patients with these risk factors should be encouraged to participate in physical therapy.

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“…Moreover, the foot-care instruments or methods used in previous studies of older people in the community with diabetes were not adequately suited to this population. In future studies, a different study design may be used based on resources presented in previous studies (Navarro-Flores et al, 2018, 2020a, 2020c, 2021Sánchez-Gómez et al, 2020;Simón-Pérez et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Effects of Nurse and Care Worker-led Foot-Care Program on Older People’s Foot Conditions: Before and After Intervention Study

et al. 2021

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Introduction An increasing number of older people with frailty in Japan use geriatric day care centers. Older people who have been certified as requiring long-term care attend centers during the day and receive nursing care help with bathing, excretion, meals, and functional training services. Many older people have foot problems with need foot care by nurses and care workers (NCWs) at geriatric day care centers. Objective This study explored the effects of NCWs’ foot-care programs on the foot conditions of older people attending daytime services. Methods A before-after intervention study was conducted at geriatric day care centers for older people, where the foot-care program was presented by NCWs for two months. The foot conditions of 23 clients (8 men, 15 women, mean age = 78.6 years, standard deviation = 9.2) were assessed before and after the program. Changes in foot condition and clients’ perceptions after the study were analyzed through descriptive statistics, McNemar, and paired t-tests. Results Although dramatic changes in foot conditions were not observed, some conditions were improved or maintained. Changes were observed in mean dry skin scores ( p < .01; right foot: 1.6→1.1, left foot: 1.6→1.1), skin lesions and long nails (skin lesions R: 0.2→0.1; long nail R: 1.4→1.0, L: 1.1→0.8), and edema (R: 43.5%→39.1%, L: 52.2%→47.8%). Further, clients started perceiving that foot health is important and discussed their feet with staff more often. Conclusion The NCWs’ foot-care program was effective in maintaining and improving foot health in older people and positively affected their perception of foot care.

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Stiffness degree of ankle range of motion in diabetic patients with atypical amputation

Cited by 21 publications

References 21 publications

Reamputation in patients with diabetes-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

Reamputation in patients with diabetes-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

Re-amputation in patients with diabetes -related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

Effects of Nurse and Care Worker-led Foot-Care Program on Older People’s Foot Conditions: Before and After Intervention Study

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