Examining characteristics of those who receive pedorthic services: A clinical audit.

Diabetes-related foot complications, including neuropathic plantar forefoot ulcers, are a significant contributor to morbidity and increased healthcare costs. This retrospective clinical audit examines the characteristics of people accessing pedorthics services who are at risk of neuropathic plantar forefoot ulcer (re)occurrence and the pathways and funding models used to access these services. A clinical record audit was conducted on all patients accessing a pedorthics service who had diabetes and neuropathy with a history of plantar forefoot ulceration.

Footwear and insole design parameters to prevent occurrence and recurrence of neuropathic plantar forefoot ulcers in patients with diabetes: a series of N-of-1 trial study protocol.

Background: Foot complications occur in conjunction with poorly controlled diabetes. Plantar forefoot ulceration contributes to partial amputation in unstable diabetics, and the risk increases with concomitant neuropathy. Reducing peak plantar forefoot pressure reduces ulcer occurrence and recurrence.

Embodied experiences and existential reflections of the oldest old.

The aim of this study was to learn more about the embodied experiences of people over 85 years and to gain a better understanding of how they make sense of the existential issues faced at this unique stage of life. This research is philosophically and methodologically underpinned by existential phenomenology, in particular embodiment theory, which allows exploration of everyday experiences and the personal meanings attributed to them. In-depth interviews with twenty purposively selected individuals were analysed using Interpretive Phenomenological Analysis.

The Phenomenology of the Body After 85 Years.

The aim of this study was to describe the phenomenology of the body after 85 years, addressing the following question: Within the paradigm of existential phenomenology, this study was philosophically and methodologically underpinned by embodiment theory, positioning the body as the starting point for the exploration of lived experience. In-depth interviews with 20 purposively selected individuals were analyzed using van Manen's context-sensitive phenomenological orientation. Findings indicated that the body was experienced primarily in negative terms, as compromising engagement in meaningful activity, independence, safety, vitality, dignity, and identity.

Footwear and insole design features that reduce neuropathic plantar forefoot ulcer risk in people with diabetes: a systematic literature review.

Background: In people with diabetes, offloading high-risk foot regions by optimising footwear, or insoles, may prevent ulceration. This systematic review aimed to summarise and evaluate the evidence for footwear and insole features that reduce pathological plantar pressures and the occurrence of diabetic neuropathy ulceration at the plantar forefoot in people with diabetic neuropathy.

Methods: Six electronic databases (Medline, Cinahl, Amed, Proquest, Scopus, Academic Search Premier) were searched in July 2019.

Accurate Noninvasive Arterial Assessment of the Wounded Lower Limb: A Clinical Challenge for Wound Practitioners.

Arterial investigations are an essential part of lower extremity wound assessment. The results of these investigations assist the wound clinician to determine the etiology of the wound, predict healing capacity, and inform further management. There are a number of noninvasive testing methods available to practitioners, all with varying levels of reliability and accuracy.

Life as Experienced Within and Through the Body After the Age of 85 Years: A Metasynthesis of Primary Phenomenological Research.

The body is central to the experience of aging. In this metasynthesis, the authors located, analyzed, and reconceptualized phenomenological research on how life is experienced within and through the body after 85 years. Sandelowski and Barroso's metasynthesis method was employed.

Factors associated with type of footwear worn inside the house: a cross-sectional study.

Background: In specific populations, including those at risk of falls or foot ulcers, indoor footwear is an important aspect of preventative care. This study aims to describe the indoor footwear worn most over the previous year in a sample representative of the Australian inpatient population, and to explore the sociodemographic, medical, foot condition and foot treatment history factors associated with the indoor footwear worn.

Methods: This was a secondary analysis of data collected from inpatients admitted to five hospitals across Queensland, Australia.

Factors associated with wearing inadequate outdoor footwear in populations at risk of foot ulceration: A cross-sectional study.

Background: Few studies have investigated if people at risk of foot ulceration actually wear the footwear recommended by best practice guidelines to prevent foot ulceration. This study aimed to investigate the prevalence of, and factors associated with, wearing inadequate outdoor footwear in those with diabetes or peripheral neuropathy in an inpatient population.

Methods: This was a secondary analysis of a multi-site cross-sectional study investigating foot conditions in a large representative inpatient population admitted into hospital for any medical reason on one day.

Self-reported physical activity in community-dwelling adults with diabetes and its association with diabetes complications.

Aims: To describe the physical activity levels of an Australian community-based adult population with diabetes, and investigate the interaction between diabetes complications and physical activity.

Methods: Anthropometric, demographic, biochemical and self-reported physical activity measures (IPAQ) were performed. Associations and multiple regression analyses were undertaken between physical activity, known risk factors for diabetes complications, and history of cardiovascular disease (CVD), neuropathy and foot ulceration obtained from medical records.

Health Practitioners' Perceptions of Falls and Fall Prevention in Older People: A Metasynthesis.

Fall prevention has received a great deal of consideration and funding, however fall rates have not reduced accordingly. Health practitioners are key stakeholders in the process of implementing fall prevention evidence into their clinical assessment and management of older people at risk of falling. Investigating health practitioners' clinical experiences and perceptions has been identified as a means to enhance the translation of knowledge.

How sensitive and specific is continuous-wave Doppler for detecting peripheral arterial disease in people with and without diabetes? A cross-sectional study.

Background: Continuous-wave Doppler is frequently used for detecting peripheral arterial disease in patients with diabetes; however, there is limited evidence investigating diagnostic accuracy. This study aimed to determine sensitivity and specificity of continuous-wave Doppler for detecting peripheral arterial disease in populations with, and without, diabetes and to investigate the influence of disease severity on sensitivity of continuous-wave Doppler for detecting peripheral arterial disease.

Results: Data from 396 participants were included.

Independent factors associated with wearing different types of outdoor footwear in a representative inpatient population: a cross-sectional study.

Background: Footwear can have both a positive and negative impact on lower limb health and mobility across the lifespan, influencing the risk of foot pain, ulceration, and falls in those at risk. Choice of footwear can be influenced by disease as well as sociocultural factors, yet few studies have investigated the types of footwear people wear and the profiles of those who wear them. The aim of this study was to investigate the prevalence and factors associated with outdoor footwear type worn most often in a representative inpatient population.

Diagnostic accuracy of the postexercise ankle-brachial index for detecting peripheral artery disease in suspected claudicants with and without diabetes.

The postexercise ankle-brachial index (ABI) is recommended in patients with normal resting ABI when peripheral artery disease (PAD) is suspected. The aims of this study were to determine the comparative diagnostic accuracy of the resting and postexercise ABI for detecting PAD, and, the effect of the presence of diabetes on these. Three methods of interpretation currently in use were also investigated: a reduction in postexercise ABI by >20% compared to resting ABI, an ABI value of ≤0.

Venous Thromboembolism in Podiatric Foot and Ankle Surgery.

Background: The extent to which podiatric surgeons follow venous thromboembolism guidelines is unknown. The aim of this study therefore, was 2-fold: (a) to determine the rate of venous thromboembolism following podiatric surgery and (b) to investigate the factors that influence the use of thromboprophylaxis.

Methods: Data from 4238 patients who underwent foot and ankle surgery over 2 years were analyzed.

Diagnostic accuracy of resting systolic toe pressure for diagnosis of peripheral arterial disease in people with and without diabetes: a cross-sectional retrospective case-control study.

Background: The resting systolic toe pressure (TP) is a measure of small arterial function in the periphery. TP is used in addition to the ankle-brachial index when screening for peripheral arterial disease (PAD) of the lower limb in those with diabetes, particularly in the presence of lower limb medial arterial calcification. It may be used as an adjunct assessment of lower limb vascular function and as a predictor of wound healing.

Post-occlusive reactive hyperaemia of skin microvasculature and foot complications in type 2 diabetes.

Aims: Diabetes-related microvascular disease has been implicated in the development of foot ulceration and amputation. Assessment of microvascular function may be effective in identifying those at risk of diabetic foot complications. We investigated the relationship between active or previous foot complication and post-occlusive reactive hyperaemia (PORH) measured by laser-Doppler fluxmetry (LDF) in people with type 2 diabetes.

Computed tomography derived bone density measurement in the diabetic foot.

Background: The accurate and reliable measurement of foot bone density is challenging and there is currently no gold standard technique. Such measurement is particularly valuable in populations at risk of foot bone pathology such as in those with long term diabetes. With research and development, computed tomography may prove to be a useful tool for this assessment.

Peripheral sensory neuropathy is associated with altered postocclusive reactive hyperemia in the diabetic foot.

Objective: This study examined whether the presence of peripheral sensory neuropathy or cardiac autonomic deficits is associated with postocclusive reactive hyperemia (reflective of microvascular function) in the diabetic foot.

Research Design And Methods: 99 participants with type 2 diabetes were recruited into this cross-sectional study. The presence of peripheral sensory neuropathy was determined with standard clinical tests and cardiac autonomic function was assessed with heart rate variation testing.

Foot bone density in diabetes may be unaffected by the presence of neuropathy.

Aims: Neuropathies are common complications of diabetes and are proposed to influence peripheral bone, principally via an altered vascular supply. This study aimed to determine the relationship between subtypes of neuropathy and vascular reactivity on foot bone density in people with diabetes.

Methods: A case-control observational design was utilised with two groups: those with diabetic peripheral large fibre neuropathy (n=23) and a control group with diabetes but without neuropathy (n=23).

Intra-tester and inter-tester reliability of post-occlusive reactive hyperaemia measurement at the hallux.

Background: Post-occlusive reactive hyperaemia (PORH) is a measurement of the vasodilatory capacity of the microvasculature that is associated with cardiovascular disease, peripheral arterial disease and foot ulceration. The reliability of its measurement in the hallux (great toe) for clinical and research purposes has not been adequately assessed. This study assesses both the intra-tester reliability and inter-tester reliability of four methods of assessing PORH in the hallux.

The relationship between foot motion and lumbopelvic-hip function: a review of the literature.

Excessive pronation has been implicated in the development of numerous overuse injuries of the lower limb and is suggested to cause more proximal biomechanical dysfunction. Functional foot orthoses (FFO) are frequently prescribed for lower limb injury associated with excessive foot pronation and have been demonstrated to have efficacy with specific conditions. However, the mechanism of action of FFO is largely unknown.