Therapeutic footwear for people with diabetes

Cavanagh, Peter R.

doi:10.1002/dmrr.435

Cited by 62 publications

(38 citation statements)

References 24 publications

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“…Further complications, such as plantar ulceration, PFAs and TTAs, increase the risk of plantar injury in this patient population during walking. However, since walking is an integral component of activities of daily life [34], we suggest maintenance of essential daily walking in protective footwear with foot care [35,36] and appropriate modifications in the gait pattern to reduce the MPP [37].…”

Section: Discussionmentioning

confidence: 99%

Walking performance in people with diabetic neuropathy: benefits and threats

et al. 2006

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Aims/hypothesis Walking is recommended as an adjunct therapy to diet and medication in diabetic patients, with the aim of improving physical fitness, glycaemic control and body weight reduction. Therefore we evaluated walking activity on the basis of capacity, performance and potential risk of plantar injury in the diabetic population before it can be prescribed safely. Subjects, materials and methods Twenty-three subjects with diabetic neuropathy (DMPN) were compared with 23 patients with current diabetic foot ulcers, 16 patients with partial foot amputations and 22 patients with trans-tibial amputations. The capacity for walking was measured using a total heart beat index (THBI). Gait velocity and average daily strides were measured to assess the performance of walking, and its impact on weight-bearing was studied using maximum peak pressure. Results THBI increased (p<0.01) and gait velocity and daily stride count fell (p<0.001 for both) with progression of foot complications. The maximum peak pressures over the affected foot of patients with diabetic foot ulcers (p<0.05) and partial foot amputations (p<0.01) were higher than in the group with DMPN. On the contralateral side, the diabetic foot ulcer group showed higher maximum peak pressure over the total foot (p<0.05), and patients with partial foot amputations (p<0.01) and trans-tibial amputations (p<0.05) showed higher maximum peak pressure over the heel. Conclusions/interpretation Walking capacity and performance decrease with progression of foot complications. Although walking is recommended to improve fitness, it cannot be prescribed in isolation, considering the increased risk of plantar injury. For essential walking we therefore recommend the use of protective footwear. Walking exercise should be supplemented by partial or non-weightbearing exercises to improve physical fitness in diabetic populations.

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Section: Discussionmentioning

confidence: 99%

Walking performance in people with diabetic neuropathy: benefits and threats

et al. 2006

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“…[15,105] Suitable footwear with properly fitted in-soles and enough space between the toes is mandatory. [15,106] Patients with deformities or a history of foot ulcer need special bespoke shoes [15] . It is now becoming apparent that zealous proactive care may result in fewer amputations and a higher quality of life.…”

Section: The Diabetic Foot In Renal Failure: Prevention and Treatmentmentioning

confidence: 99%

The Diabetic Foot in End Stage Renal Disease

et al. 2007

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Diabetic foot lesions remain a major cause of morbidity in patients with renal failure, especially those on dialysis. Foot complications are encountered at a more than twofold frequency in diabetic patients with end-stage renal disease, and the rate of amputations is 6.5-10 times higher in comparison to the general diabetic population. The causal pathways of the diabetic foot in renal failure are multiple and inter-related. Three major pathologies-neuropathy, ischemia, and infection-are the main contributory factors. Increased awareness of this condition and careful clinical examination are indispensable to avoid serious complications. Appropriate management needs to address all contributory factors. Treatment options include revascularization, off-loading to relieve high-pressure areas, and aggressive control of infection. Equally important is the collaboration between health care providers in a multidisciplinary foot care setting. Moreover, patient education on the measures required to achieve both primary and secondary prevention is of great value. Certainly, technical innovations have made considerable progress possible, but there is a need for further improvement to reduce the number of amputations.

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“…Usability is "the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction, in a specified context of use" (International Organization for Standardization [ISO], 9241-11). Within the domains of usability stated, a more positive score on any of the following aspects has been associated with a higher frequency of use of OS: benefits of OS with regard to walking capacities, wound healing, or pain reduction (domain effectiveness); comfort and ease of use and the efficiency of the delivery process of OS (domain efficiency); and cosmetic appearance and communication with the medical specialist or orthopedic shoe technician (domain satisfaction) [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. However, only one study has been conducted in which the associations between use and aspects of all domains of usability have been studied and that was conducted only with patients with degenerative disorders of the foot [10].…”

Section: Introductionmentioning

confidence: 99%

“…However, only one study has been conducted in which the associations between use and aspects of all domains of usability have been studied and that was conducted only with patients with degenerative disorders of the foot [10]. The focus of other studies has been on some aspects of one or two domains of usability and often in one specific group of patients only [4][5][6][7][8][9][11][12][13][14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Use and usability of custom-made orthopedic shoes

Netten

Jannink

Hijmans³

et al. 2010

JRRD

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Abstract-The goal of this study was to investigate the use of custom-made orthopedic shoes (OS) and the association between the use of OS and the most relevant aspects of their usability. Over a 6-month period, patients meeting the inclusion criteria were recruited by 12 orthopedic shoe companies scattered throughout the Netherlands and asked to complete a questionnaire composed of a pre-and post-OS section. Patients with different pathologies were included in the study (n = 339; response 67%). Mean age of the patients was 63 +/-15 years, and 38% were male. Three months after delivery, 81% of the patients used their OS frequently (4-7 days/week), 13% occasionally (1-3 days/week), and 6% did not use their OS. Associations were found between use and all measured aspects of usability (p-values varied from <0.001 to 0.028). Patients who used their OS more often had a more positive opinion regarding all the aspects of usability. We conclude that all aspects of the usability of OS are relevant in relation to their use and should be taken into account when prescribing and evaluating OS.

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Therapeutic footwear for people with diabetes

Cited by 62 publications

References 24 publications

Walking performance in people with diabetic neuropathy: benefits and threats

Walking performance in people with diabetic neuropathy: benefits and threats

The Diabetic Foot in End Stage Renal Disease

Use and usability of custom-made orthopedic shoes

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