title: Protective socks for people with diabetes: a systematic review and narrative analysis.
abstract: Padded socks to protect the at-risk diabetic foot have been available for a number of years. However, the evidence base to support their use is not well known. We aimed to undertake a systematic review of padded socks for people with diabetes. Additionally, a narrative analysis of knitted stitch structures, yarn and fibres used together with the proposed benefits fibre properties may add to the sock. Assessment of the methodological quality was undertaken using a quality tool to assess non-randomised trials. From the 81 articles identified only seven met the inclusion criteria. The evidence to support to use of padded socks is limited. There is a suggestion these simple-to-use interventions could be of value, particularly in terms of plantar pressure reduction. However, the range of methods used and limited methodological quality limits direct comparison between studies. The socks were generally of a sophisticated design with complex use of knit patterns and yarn content. This systematic review provides limited support for the use of padded socks in the diabetic population to protect vulnerable feet. More high quality studies are needed; including qualitative components of sock wear and sock design, prospective randomized controlled trials and analysis of the cost-effectiveness of protective socks as a non-surgical intervention.
authors.affiliation: School of Rehabilitation & Occupation Studies, AUT University, North Shore Campus, Private Bag 92006, Auckland, 1142 New Zealand.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Otter
authors.affiliation: School of Rehabilitation & Occupation Studies, AUT University, North Shore Campus, Private Bag 92006, Auckland, 1142 New Zealand.
authors.forename: Keith
authors.initials: K
authors.lastname: Rome
authors.affiliation: School of Rehabilitation & Occupation Studies, AUT University, North Shore Campus, Private Bag 92006, Auckland, 1142 New Zealand.
authors.forename: Belinda
authors.initials: B
authors.lastname: Ihaka
authors.affiliation: School of Rehabilitation & Occupation Studies, AUT University, North Shore Campus, Private Bag 92006, Auckland, 1142 New Zealand.
authors.forename: Andrew
authors.initials: A
authors.lastname: South
authors.affiliation: Fashion Design, School of Art & Design, AUT University, WW Building, 9 Mount Street, 1010 Private Bag 92006, Auckland, 1142 New Zealand.
authors.forename: Mandy
authors.initials: M
authors.lastname: Smith
authors.affiliation: Textile and Design Laboratory, AUT University, WW Building, 9 Mount Street, 1010 Private Bag 92006, Auckland, 1142 New Zealand.
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Textile and Design Laboratory, AUT University, WW Building, 9 Mount Street, 1010 Private Bag 92006, Auckland, 1142 New Zealand.
authors.forename: Frances
authors.initials: F
authors.lastname: Joseph
authors.affiliation: Textile and Design Laboratory, AUT University, WW Building, 9 Mount Street, 1010 Private Bag 92006, Auckland, 1142 New Zealand.
authors.forename: Peter
authors.initials: P
authors.lastname: Heslop
keywords: Diabetes; Diabetic foot; Footwear; Offloading