This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.OBJECTIVE: Foot orthotics or shoe inserts are currently utilized as a common conservative treatment option for a wide variety of foot disorders. In particular, this treatment is used as a preventive measure against foot ulceration for persons with diabetes or peripheral vascular disease (dysvascular). Foot orthotics assist in the even distribution of plantar pressures as well as minimizing pressure in high risk areas during ambulation. However, there is limited objective scientific data documenting the actual benefits or effectiveness of either customized or over-the-counter foot orthoses. It is the aim of this study to determine the effects of three popular foot orthoses on plantar pressures in diabetic populations. Foot orthoses can be utilized as a preventive treatment option to reduce the risk for foot ulceration by redistributing plantar pressures. RESEARCH PLAN AND METHODS: Custom molded trilaminate foot orthoses will redistribute or reduce the peak plantar pressures in the forefoot and hindfoot of the diabetic with peripheral neuropathy to a greater extent than over the counter unmodified or contoured foot orthoses.1) Examine plantar pressures during ambulation in diabetic patients using three different commonly used foot orthoses in order to determine maximum reduction of plantar pressures. The three orthoses to be tested are: a) over the counter flat trilaminate shoe inserts, b) custom molded trilaminate shoe inserts or foot orthoses, and c) over the counter contoured plastazote and cellular urethane foot orthoses.2) Compare plantar pressure patterns across the three types of orthoses to find the most efficacious shoe insert for the diabetic patient with peripheral neuropathy. Efficacy will be evaluated by measuring reduction of peak plantar pressures, duration of peak plantar pressures, and the consistency or stability to maintain these offloading properties over a prolonged period of four weeks.CLINICAL
If a definite decrease in plantar pressures or the length of time that pressure is occurring can be documented, then orthoses would be a cost effective solution to a high cost (mental and fiscal) medical impairment in this complex medical population. This would result in high quality care and medical cost savings for both the patients and the medical system caring for them.
Showing the most recent 10 out of 600 publications
