Effect of stimulating footwear on gait and posture in people with Diabetes and foot complications

Background: We sought to determine patient and ulcer characteristics that predict wound healing in patients living with diabetes. Methods: A prospective observational study was conducted on 99 patients presenting with diabetic foot ulceration. Patient and ulcer characteristics were recorded. Patients were followed up for a maximum of 1 year. Results: After 1 year of follow-up, ulcer characteristics were more predictive of ulcer healing than were patient characteristics. Seventy-seven percent of ulcers had healed and 23% had not healed. Independent predictors of nonhealing were ulcer stage (P = .003), presence of biofilm (P = .020), and ulcer depth (P = .028). Although this study demonstrated that the baseline hemoglobin A1c reading at the start of the study was not a significant predictor of foot ulcer outcome (P = .603, resolved versus amputated), on further statistical analyses, when hemoglobin A1c was compared with the time taken for complete ulcer healing (n = 77), it proved to be significant (P = .009). Conclusions: The factors influencing healing are ulcer stage, presence of biofilm, and ulcer depth. These findings have important implications for clinical practice, especially in an outpatient setting. Prediction of outcome may be helpful for health-care professionals in individualizing and optimizing clinical assessment and management of patients. Identification of determinants of outcome could result in improved health outcomes, improved quality of life, and fewer diabetes-related foot complications.

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Causation Research on Diabetic Foot Complications—What I Learned From Roger Pecoraro: The 2021 Roger E. Pecoraro Award Lecture

10.2337/figshare.15048282 ◽

2021 ◽

Author(s):

Edward J. Boyko

Keyword(s):

Risk Factors ◽

Diabetic Foot ◽

Past History ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Clinical Information ◽

Arterial Perfusion ◽

Primary Care Population ◽

Foot Complications ◽

Patients With Diabetes

Roger Pecoraro made important contribution to diabetic foot research and is primarily responsible for instilling in me an interest in these complications. Our collaboration in the final years of his life led to the development of the Seattle Diabetic Foot Study. At the time it began, the Seattle Diabetic Foot Study was perhaps unique in being a prospective study of diabetic foot ulcer conducted in a non-specialty primary care population of patients with diabetes and without foot ulcer. Important findings from this research include the demonstration that neurovascular measurements, diabetes characteristics, past history of ulcer or amputation, body weight, and poor vision all significantly and independently predict foot ulcer risk. A prediction model from this research that included only readily available clinical information showed excellent ability to discriminate between patients who did and did not develop ulcer during follow-up (area under ROC curve=0.81 at one year). Identification of limb-specific amputation risk factors showed considerable overlap with those risk factors identified for foot ulcer, but suggested arterial perfusion as playing a more important role. Risk of foot ulcer in relation to peak plantar pressure estimated at the site of the pressure measurement showed a significant association over the metatarsal heads, but not other foot locations, suggesting that the association between pressure and this outcome may differ by foot location. The Seattle Diabetic Foot Study has helped to expand our knowledge base on risk factors and potential causes of foot complications. Translating this information into preventive interventions remains a continuing challenge.

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Causation Research on Diabetic Foot Complications—What I Learned From Roger Pecoraro: The 2021 Roger E. Pecoraro Award Lecture

Diabetes Care ◽

10.2337/dci21-0026 ◽

2021 ◽

pp. dci210026

Author(s):

Edward J. Boyko

Keyword(s):

Diabetic Foot ◽

Foot Complications

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Foot Self Efficacy dan Foot Self Care Behaviour pada Lansia dengan Diabetes Melitus

JI-KES (Jurnal Ilmu Kesehatan) ◽

10.33006/ji-kes.v3i1.126 ◽

2019 ◽

Vol 3 (1) ◽

pp. 12-18

Author(s):

Ainul Yaqin Salam ◽

Nur Hamim

Keyword(s):

Self Efficacy ◽

Self Care ◽

Cross Sectional Study ◽

Foot Care ◽

Cross Sectional ◽

Foot Complications ◽

Patients With Diabetes ◽

Main Determinants ◽

And Gender ◽

Care Behavior

AbstrakLansia dengan diabetes adalah kelompok khusus yang memiliki resiko tinggi komplikasipada kakinya. Self-efficacymenjadi salah satu determinan faktor utama untuk meningkatkan perilaku perawatan kaki. Penelitian ini bertujuan untuk mengidentifikasi tingkat efikasi diri kaki (Foot Self Efficacy) dan perilaku perawatan kaki (Foot Crae Behaviour) dan hubungannya dengan karakteristik demografis pada lansia dengan diabetes.Studi cross-sectional digunakandi Desa Karangren Kecamatan Krejengan Probolinggo dari Mei hingga Juni 2019. Kriteria khusus dipilih untuk berpartisipasi dalam penelitian ini. Para responden diwawancarai menggunakan seperangkat kuesioner yang telah divalidasi. Statistik deskriptif dan inferensial (regresi linier berganda) digunakan untuk menjawab hipotesis penelitiandengan bantuanSPSS 19. Hasil penelitian menyebutkan rata-ratafoot self-efficacysebesar 29,79 dengan standar deviasi 8,26 danrata-ratafoot care behavior sebesar 28,72 dengan SD 6,33. Terdapat hubungan positif dan signifikan antara foot self-efficacy (β = 0,43, p <0,001), tingkat pendidikan (β = 0,43, p <0,001), dan jenis kelamin (β = 0,31, p <0,001) dengan perilaku perawatan kaki. Program edukasi self-efficacydapat menjadi pertimbangan yang krusial untuk meningkatkan perilaku perawatan kaki. Lansia dengan diabetes harus diajari pemeriksaan kaki secara mandiri.Perawatan kaki diabetes yang tepat dan berkelanjutan dapat secara signifikan mencegah terjadinya komplikasi pada kaki lebih lanju yang berefek pada peningkatan kualitas hidup. Kata kunci: diabetes, lansia, efikasi diri, perilaku perawatan diri, kaki AbstractThe elderly with diabetes is a special group that has a high risk of complications in the legs. Self-efficacy is one of the main determinants of improving foot care behavior.The essential aims of this study were to identify the level of self-efficacy and foot care behavior and its relationship to demographic characteristics in elderly patients with diabetes. The cross-sectional study has been done in Karangren Village, Krejengan Probolinggo district from May to June 2019. Specific criteria were chosen to participate in this study. The respondents interviewed used a set of validated questionnaires. Descriptive and inferential statistics (multiple linear regression) were used to answer the research hypothesisby SPSS 19. The results mentioned that the average foot self-efficacy was 29.79, with a standard deviation of 8.26, and the normal foot care behavior was 28.72, with an SD of 6.33. There is a significant relationship between foot self-efficacy (β = 0.43, p <0.001), level of education (β = 0.43, p <0.001), and gender (β = 0.31, p <0.001) with foot care behavior. The self-efficacy education program can be a crucial considerateness for improving foot care behavior.Elderly with diabetes must be taught foot examinations independently. Appropriate and ongoing diabetes foot care can significantly prevent diabetic foot complications, which affect improving the quality of life. Keywords: diabetes, elderly, self-efficacy, self-care behavior, feet

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Soft Tissue Reconstruction Pyramid in the Diabetic Foot

Foot & Ankle Specialist ◽

10.1177/1938640010375113 ◽

2010 ◽

Vol 3 (5) ◽

pp. 241-248 ◽

Cited By ~ 14

Author(s):

Claire M. Capobianco ◽

John J. Stapleton ◽

Thomas Zgonis

Keyword(s):

Soft Tissue ◽

Diabetic Foot ◽

Weight Bearing ◽

Soft Tissue Coverage ◽

Soft Tissue Reconstruction ◽

Best Interest ◽

Foot Complications ◽

Uncontrolled Diabetes ◽

Wound Healing Response ◽

Tissue Reconstruction

Foot complications and ulceration are well-known sequelae to uncontrolled diabetes. Patients with chronic foot ulcers or wounds resulting from surgical debridement of deep-space infections are at continued risk for development of osteomyelitis and potential amputation. Moreover, these wounds often necessitate multiple outpatient clinic visits, daily dressing care, and prolonged periods of non—weight bearing, all of which have been shown to adversely affect the patient’s quality of life. After a prudent period of wound-healing response, the authors believe that early and aggressive soft tissue reconstruction is in the patient’s best interest and is crucial for resolution of the chronic nonhealing wound. The options for soft tissue coverage and the logical progression of application of these techniques in the diabetic foot will be described.

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