title: The best way to reduce reulcerations: if you understand biomechanics of the diabetic foot, you can do it.
abstract: Foot ulcer recurrence is still an unresolved issue. Although several therapies have been described for preventing foot ulcers, the rates of reulcerations are very high. Footwear and insoles have been recommended as effective therapies that prevent the development of new ulcers; however, the majority of studies have analyzed their effects in terms of reducing peak plantar pressure rather than ulcer relapse. Knowledge of biomechanical considerations is low, in general, in the team approach to diabetic foot because heterogeneous professionals having competence in recurrence prevention are involved. Assessment of biomechanical alterations define a foot type position; examining foot structure and recording plantar pressure could help in appropriate insole and footwear prescription and design. Patient education and compliance should be taken into consideration for better therapy success. When patients suffer from rigid deformities or have undergone an amputation, surgical offloading should be considered as an alternative.
authors.affiliation: Universidad Complutense de Madrid, Madrid, Spain diabetes@enf.ucm.es.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Lázaro-Martínez
authors.affiliation: La Paloma Hospital, Las Palmas de Gran Canaria, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Aragón-Sánchez
authors.affiliation: Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Alvaro-Afonso
authors.affiliation: Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: García-Morales
authors.affiliation: Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: García-Álvarez
authors.affiliation: Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Raúl Juan
authors.initials: RJ
authors.lastname: Molines-Barroso
mesh_terms: D001696:Biomechanical Phenomena / Q000502:physiology*; D017719:Diabetic Foot / Q000150:complications*; D019468:Disease Management; D005528:Foot / Q000503:physiopathology; D016523:Foot Ulcer / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D010349:Patient Compliance; D010353:Patient Education as Topic; D011312:Pressure / Q000009:adverse effects; D055502:Secondary Prevention / Q000193:education / Q000379:methods; D012775:Shoes
keywords: biomechanics; diabetic foot; footwear; preventing diabetic foot ulcers; reulceration