Walking casts : effect on plantar foot pressures

Ja, Birke; Ds, Sims; Wl, Buford

doi:10.1682/jrrd.1985.07.0018

Cited by 47 publications

(17 citation statements)

References 10 publications

(6 reference statements)

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“…23 Subjects lacked protective sensation if they could not detect the 5.07 monofilament on 80% of the trials. 28 Stiffness measurements. In order to verify that the stiffness measurements were truly passive (no active muscle contractions elicited), electromyographic (EMG) monitoring (GCS-67 Multichannel Electromyographic System*) was used throughout the procedure.…”

Section: Methodsmentioning

confidence: 99%

“…Peripheral neuropathy was characterized by the loss of protective sensation on the plantar surface of the foot, measured using Semmes-Weinstein monofilaments. 28 Exclusion criteria consisted of a current or previous severe orthopedic injury to the lower extremity (eg, ankle fracture, joint fusion, joint replacement) or a current or previous neurological insult (eg, cerebrovascular accident).…”

Section: Subjectsmentioning

confidence: 99%

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Passive Ankle Stiffness in Subjects With Diabetes and Peripheral Neuropathy Versus an Age-Matched Comparison Group

Salsich

Mueller

Sahrmann³

2000

Physical Therapy

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Background and Purpose. Patients with diabetes mellitus and peripheral neuropathy (DM and PN) often complain of joint stiffness. Although stiffness may contribute to some of the impairments and functional limitations found in these patients, it has not been quantified in this population. The purpose of this study was to quantify and compare passive ankle stiffness and dorsiflexion (DF) range of motion in subjects with DM and PN versus an age-matched comparison group. Subjects. Thirty-four subjects were tested (17 subjects with DM and PN and 17 subjects in an age-matched comparison group). There were 10 male subjects and 7 female subjects in each group. Methods. A Kin-Com dynamometer was used to measure passive plantar flexor torque as each subject's ankle was moved from plantar flexion into dorsiflexion at 60°/s. The following variables were compared using a Student t test: initial angle (angle of onset of plantar flexor torque), maximal dorsiflexion angle, plantar flexor muscle excursion (difference between initial angle and maximal dorsiflexion angle), slope of the first half of the plantar flexor torque curve (stiffness 1 measurement), and slope of the second half of the plantar flexor torque curve (stiffness 2 measurement). Results. The subjects with DM and PN group had smaller maximal dorsiflexion angles and less plantar flexor muscle excursion than the comparison group. There was no difference in initial angle, stiffness 1 measurement, or stiffness 2 measurement. Conclusion and Discussion. Although the subjects with DM and PN had less dorsiflexion range of motion than did the comparison group, there was no difference in stiffness between the groups. This finding suggests that people with DM and PN have "short" versus "stiff" plantar flexor muscles. [Salsich GB, Mueller MJ, Sahrmann SA. Passive ankle stiffness in subjects with diabetes and peripheral neuropathy versus an age-matched comparison group. Phys Ther. 2000;80:352-362.]

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Section: Methodsmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

Passive Ankle Stiffness in Subjects With Diabetes and Peripheral Neuropathy Versus an Age-Matched Comparison Group

Salsich

Mueller

Sahrmann³

2000

Physical Therapy

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“…TCC has also been shown to reduce forefoot pressure and facilitate wound healing. 4 The ankle joint was casted in a neutral position throughout the immobilization period. Once dry, the TCC was bivalved to allow for swelling.…”

Section: Tendo-achilles Lengthening Procedures and Treatmentmentioning

confidence: 99%

Effects of a Tendo-Achilles Lengthening Procedure on Muscle Function and Gait Characteristics in a Patient With Diabetes Mellitus

Hastings¹,

Mueller²,

Sinacore³

et al. 2000

J Orthop Sports Phys Ther

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Study Design: Case report with repeated measures. Objectives: To describe the effects of a tendo-Achilles lengthening (TAL) and total contact casting (TCC) on wound healing, motion, plantar pressure, and function in a patient with diabetes mellitus, peripheral neuropathy, neuropathic ulcer, and limited doniflexion range of motion (DFROM). Background: Limited DFROM has been associated with increased forefoot pressures and skin breakdown. A TAL was expected to increase DFROM and reduce forefoot pressures during walking, but the influence on muscle performance and function was unknown. Methods and Measures: The patient was a 42-year-old man with a 20-year history of type 1 diabetes (NIDDM) and a recurrent neuropathic plantar ulcer. Outcome measures were DFROM, isokinetic plantar flexor muscle peak torque, in-shoe and barefoot peak plantar pressure, physical performance test (PPT) score, and peak ankle and hip moments during walking obtained from an automated gait analysis. All tests were completed pre-TAL, 8 weeks post-TAL (after immobilization in a TCC), and 7 months post-TAL. Results: The wound healed in 40 days. The TAL resulted in a sustained increase in DFROM (0 to 18"). Plantar flexor peak torque was reduced by 21% 8 weeks after the TAL compared with the torque before surgery but recovered fully at 7 months. Seven months following TAL, in-shoe forefoot peak plantar pressure was reduced by 55%, barefoot pressure decreased by 14% PPT score increased by 24%, peak ankle plantar flexor moment remained decreased by 30%, and the peak hip flexor moment increased by 41% during walking. Conclusion: For this patient, a TAL resulted in short-term deficits in peak plantar flexor torque, but a 7-month follow-up showed improvements in ankle DFROM, walking ability, and a decrease in forefoot in-shoe peak plantar pressure. ) Orthop Sports Phys Ther 2000; 30:85-90.

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“…Brike JA et al 16 reported a 75% to 84% reduction in peak pressure at the 1st and 3rd metatarsal heads respectively, when a person walked in the total contact cast compared to normal shoes. Therefore, the utility of contact-casting is in reducing peak plantar pressures, through increasing the surface area of the foot.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Study of Diabetic Foot Ulcer - An Account of ‘The Role of Focused Wound Care’ and ‘Pressure Relieving Measures’ in Healing

Ray¹,

Haldar²,

Mandal³

et al. 2016

jemds

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BACKGROUNDDiabetes mellitus is the epidemic of current generation, and the diabetic foot ulcers are major complications. Though DFU formation itself indicates disease progression, the failure to treat it effectively contributes further to deterioration in patient's quality of life and increased mortality. DFU often leads to infections, osteomyelitis or gangrene, and consistently being ascertained as significant risk factor for lower extremity amputation.

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Walking casts : effect on plantar foot pressures

Cited by 47 publications

References 10 publications

Passive Ankle Stiffness in Subjects With Diabetes and Peripheral Neuropathy Versus an Age-Matched Comparison Group

Passive Ankle Stiffness in Subjects With Diabetes and Peripheral Neuropathy Versus an Age-Matched Comparison Group

Effects of a Tendo-Achilles Lengthening Procedure on Muscle Function and Gait Characteristics in a Patient With Diabetes Mellitus

Clinicopathological Study of Diabetic Foot Ulcer - An Account of ‘The Role of Focused Wound Care’ and ‘Pressure Relieving Measures’ in Healing

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