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

Abstract

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.