title: Longitudinal in-shoe foot pressure relief achieved by specially designed footwear in high risk diabetic patients.
abstract: Specially designed Thor-Lo footwear has been shown to reduce the in-shoe foot pressures in diabetic patients at risk of foot ulceration when compared to their own footwear. Fifty at high risk patients 32 (64%) males, 17 (34%) type 1 diabetes) have been provided with this foot wear and have been followed up for 6 months. Mean age was 57.6 (range, 34-78) years, duration of diabetes 22.4 (range, 4-50) years, Neuropathy Symptom Score 3.36 +/- 2.96 (mean +/- S.D.), Neuropathy Disability Score 16.8 +/- 6.83, VPT 43.4 +/- 11.8 Volts while 43 (86%) could not feel a 5.07 or smaller Semmes-Weinstein monofilament. Forty-two (84%) patients were re-examined at an interim visit 3 months after baseline, while 37 (74%) completed the study. In-shoe peak forces and pressures were measured using the F-Scan system. No difference was found among the peak force among baseline (95.5 +/- 26 kg), interim (96.5 +/- 33) and final visit (97.7 +/- 25.2, P + NS). There was no difference in peak pressures at the baseline (3.98 +/- 1.42 kg.cm-2), second visit (4.13 +/- 2.30) and the final visit (4.25 +/- 1.51). Nine (18%) patients developed foot problems and one died during the study. We conclude that no changes in foot pressures were found over a period of 6 months of continuous usage of the specially designed footwear in a group of diabetic patients at risk of foot ulceration. Further prospective studies are required to evaluate the impact of specially designed footwear in reducing the rate of foot ulceration.
authors.affiliation: Department of Surgery, Deaconess-Joslin Foot Center, Boston, MA 02215, USA.
authors.forename: V M
authors.initials: VM
authors.lastname: Donaghue
authors.forename: M R
authors.initials: MR
authors.lastname: Sarnow
authors.forename: J M
authors.initials: JM
authors.lastname: Giurini
authors.forename: J S
authors.initials: JS
authors.lastname: Chrzan
authors.forename: G M
authors.initials: GM
authors.lastname: Habershaw
authors.forename: A
authors.initials: A
authors.lastname: Veves
mesh_terms: D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D017719:Diabetic Foot / Q000453:epidemiology / Q000517:prevention & control*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000453:epidemiology / Q000517:prevention & control*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D011312:Pressure; D012307:Risk Factors; D012775:Shoes