An immediate effect of custom-made ankle foot orthoses on postural stability in older adults.

Background: Foot and ankle problems are highly prevalent fall risks in the elderly. Ankle foot orthoses designed to stabilize the foot and ankles have been studied within specific patient groups, but their efficacy with a less restrictive elderly population is unknown. This study investigated if custom-made ankle foot orthoses improve postural stability in older adults.

Does the diabetic foot have a significant impact on selected psychological or social characteristics of patients with diabetes mellitus?

Unlabelled: The aim of our case-control study was to compare selected psychological and social characteristics between diabetic patients with and without the DF (controls).

Methods: 104 patients with and 48 without DF were included into our study. Both study groups were compared in terms of selected psychosocial characteristics.

Impact of podiatry resident experience level in hallux valgus surgery on postoperative outcomes.

Background: Despite modern advancements in transosseous fixation and operative technique, hallux valgus (i.e., bunion) surgery is still associated with a higher than usual amount of patient dissatisfaction and is generally recognized as a complex and nuanced procedure requiring precise osseous and capsulotendon balancing.

Hallux valgus surgery may produce early improvements in balance control: results of a cross-sectional pilot study.

Background: Hallux valgus (HV) is associated with poorer performance during gait and balance tasks and is an independent risk factor for falls in older adults. We sought to assess whether corrective HV surgery improves gait and balance.

Methods: Using a cross-sectional study design, gait and static balance data were obtained from 40 adults: 19 patients with HV only (preoperative group), 10 patients who recently underwent successful HV surgery (postoperative group), and 11 control participants.

A growing troubling triad: diabetes, aging, and falls.

There is a significant and troubling link between diabetes (DM) and falls in the elderly. Individuals with DM are prone to fall for reasons such as decreased sensorimotor function, musculoskeletal/neuromuscular deficits, foot and body pain, pharmacological complications, and specialty (offloading) footwear devices. Additionally, there is some concern that DM patients are prone to have more severe problems with falls than non-DM individuals.

Safety and efficacy of mild compression (18-25 mm Hg) therapy in patients with diabetes and lower extremity edema.

Background: Patients with diabetes often present with lower extremity (LE) edema; however, because of concomitant peripheral arterial disease, compression therapy is generally avoided by providers in fear of compromising arterial circulation. This pilot study sought to assess whether diabetic socks with mild compression (18-25 mm Hg) can reduce LE edema in patients with diabetes without negatively impacting vascularity.

Methods: Eighteen subjects (9 males, 9 females) aged 61 ± 11 years with diabetes, LE edema, and a mean ankle-brachial index (ABI) of 1.

Virtualizing the assessment: a novel pragmatic paradigm to evaluate lower extremity joint perception in diabetes.

Background: Individuals with diabetes have a higher risk of falls and fall-related injuries. People with diabetes often develop peripheral neuropathy (DPN) as well as nerve damage throughout the body. In particular, reduced lower extremity proprioception due to DPN may cause a misjudgment of foot position and thus increase the risk of fall.

Dynamic plantar loading index: understanding the benefit of custom foot orthoses for painful pes cavus.

The purpose of this study was to evaluate a new method showing how custom foot orthoses (CFO) improve dynamics of plantar loading. The method is based on the probability distribution of peak pressure time series and is quantified using the Regression Factor (RF). RF is a least square regression slope between the experimentally observed plantar pressure magnitude probability distribution and a modeled Gaussian shape.

Impact of strut height on offloading capacity of removable cast walkers.

Background: Reducing weight-bearing stress to diabetic foot ulcers is critical to healing and commonly called offloading. Removable cast walkers are frequently used for offloading; however, patient compliance is often poor. Walkers commonly extend to the knee.

Dynamic footprint measurement collection technique and intrarater reliability: ink mat, paper pedography, and electronic pedography.

Background: Identifying the variability of footprint measurement collection techniques and the reliability of footprint measurements would assist with appropriate clinical foot posture appraisal. We sought to identify relationships between these measures in a healthy population.

Methods: On 30 healthy participants, midgait dynamic footprint measurements were collected using an ink mat, paper pedography, and electronic pedography.

Laboratory in a box: wearable sensors and its advantages for gait analysis.

Until recently, many gait studies explored potential gait alteration due to various disorders in the gait lab and using camera based systems and force platforms. However, these strategies may not replicate normal outdoor walking. Using this equipment, it is more difficult to measure the variability of walking which is important for maintaining balance and responding to different walking challenges.

Importance of time spent standing for those at risk of diabetic foot ulceration.

Objective: Despite the high cumulative plantar stress associated with standing, previous physical activity reports of diabetic patients at risk of foot ulceration have not taken this activity into account. This study aimed to monitor spontaneous daily physical activity in diabetic peripheral neuropathy (DPN) patients and examine both walking and standing activities as important foot-loading conditions.

Research Design And Methods: Thirteen DPN patients were asked to wear a body-worn sensor for 48 h.

Diabetic foot biomechanics and gait dysfunction.

Background: Diabetic foot complications represent significant morbidity and precede most of the lower extremity amputations performed. Peripheral neuropathy is a frequent complication of diabetes shown to affect gait. Glycosylation of soft tissues can also affect gait.

Assessing postural control and postural control strategy in diabetes patients using innovative and wearable technology.

Introduction: Currently, diagnosis of patients with postural instability relies on a rudimentary clinical examination. This article suggests an innovative, portable, and cost-effective prototype to evaluate balance control objectively.

Methods: The proposed system uses low-cost, microelectromechanical sensor, body-worn sensors (BalanSens) to measure the motion of ankle and hip joints in three dimensions.

A proof-of-concept study for measuring gait speed, steadiness, and dynamic balance under various footwear conditions outside of the gait laboratory.

Background: This pilot study examined the effect of custom and prefabricated foot orthoses on self-selected walking speed, walking speed variability, and dynamic balance in the mediolateral direction.

Methods: The gait of four healthy participants was analyzed with a body-worn sensor system across a distance of at least 30 m outside of the gait laboratory. Participants walked at their habitual speed in four conditions: barefoot, regular shoes, prefabricated foot orthoses, and custom foot orthoses.

Does footwear type impact the number of steps required to reach gait steady state?: an innovative look at the impact of foot orthoses on gait initiation.

Many studies have attempted to better elucidate the effect of foot orthoses on gait dynamics. To our knowledge, most previous studies exclude the first few steps of gait and begin analysis at steady state walking. These unanalyzed steps of gait may contain important information about the dynamic and complex processes required to achieve equilibrium for a given gait velocity.

Can we predict outcome of surgical reconstruction of Charcot neuroarthropathy by dynamic plantar pressure assessment?--A proof of concept study.

The joint deformity that arises as a result of Charcot neuroarthropathy, leads to gait modification. Ulceration risk associated with the deformity is generally assessed by measuring plantar pressure magnitude (PPM). However, as PPM is partially dependent on gait speed and treatment interventions may impact speed, the use of PPM to validate treatment is not ideal.

Gait changes with the use of Heelys: a case study.

Heelys shoes are a novel athletic shoe with a concealed wheel. They have been popular among youths since their introduction in 2000. This case study serves as a first look into the biomechanical implications of Heelys shoes on gait.

Clinical factors associated with a conservative gait pattern in older male veterans with diabetes.

Background: Patients with diabetes and peripheral neuropathy are at higher risk for falls. People with diabetes sometimes adopt a more conservative gait pattern with decreased walking speed, widened base, and increased double support time. The purpose of this study was to use a multivariate approach to describe this conservative gait pattern.

A method for assessing off-loading compliance.

Background: Off-loading excessive pressure is essential to healing diabetic foot ulcers. However, many patients are not compliant in using prescribed footwear or off-loading devices. We sought to validate a method of objectively measuring off-loading compliance via activity monitors.

Does walking strategy in older people change as a function of walking distance?

This study investigates whether the spatio-temporal parameters of gait in the elderly vary as a function of walking distance. The gait pattern of older subjects (n=27) over both short (SWD<10 m) and long (LWD>20 m) walking was evaluated using an ambulatory device consisting of body-worn sensors (Physilog). The stride velocity (SV), gait cycle time (GCT), and inter-cycle variability of each parameter (CV) were evaluated for each subject.

Use of pressure offloading devices in diabetic foot ulcers: do we practice what we preach?

Objective: Pressure mitigation is crucial for the healing of plantar diabetic foot ulcers. We therefore discuss characteristics and considerations associated with the use of offloading devices.

Research Design And Methods: A diabetic foot ulcer management survey was sent to foot clinics in all 50 states and the District of Columbia in 2005.