Abstract:
BACKGROUND:We assessed the efficacy of customized foot orthotic therapy by comparing reulceration rates, minor amputation rates, and work and daily living activities before and after therapy. Peak plantar pressures and peak plantar impulses were compared with the patients not wearing and wearing their prescribed footwear. METHODS:One hundred seventeen patients with diabetes were prescribed therapeutic insoles and footwear based on the results of a detailed biomechanical study and were followed for 2 years. All of the patients had a history of foot ulcers, but none had undergone previous orthotic therapy. RESULTS:Before treatment, the reulceration rate was 79% and the amputation rate was 54%. Two years after the start of orthotic therapy, the reulceration rate was 15% and the amputation rate was 6%. Orthotic therapy reduced peak plantar pressures in patients with reulcerations and in those without (P < .05), although a significant decrease in peak plantar impulses was achieved only in patients not experiencing reulceration. Sick leave was reduced from 100% to 26%. CONCLUSIONS:Personalized orthotic therapy targeted at reducing plantar pressures by off-loading protects high-risk patients against reulceration. Treatment reduced the reulceration rate and peak plantar pressures, leading to patients' return to work or other activities.
journal_name
J Am Podiatr Med Assocjournal_title
Journal of the American Podiatric Medical Associationauthors
Fernandez ML,Lozano RM,Diaz MI,Jurado MA,Hernandez DM,Montesinos JVdoi
10.7547/1030281subject
Has Abstractpub_date
2013-07-01 00:00:00pages
281-90issue
4eissn
8750-7315issn
1930-8264pii
103/4/281journal_volume
103pub_type
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