Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지

A Study on the Therapeutic Shoes for Diabetic Patients

당뇨병 환자의 치료용 신발에 대한 연구

  • Lee, Woo-Chun (Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University) ;
  • Park, Sung-Sik (Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University)
  • 이우천 (인제대학교 서울백병원 정형외과학교실) ;
  • 박성식 (인제대학교 서울백병원 정형외과학교실)
  • Published : 2004.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To investigate the characteristics of the patients and therapeutic shoes for diabetic patients. Materials and Methods: Forty two diabetic patients who had their own therapeutic shoes which were prescribed somewhere else were studied from March 2003 to December 2003. There were 27 males and 15 females, and the mean age was 62.1 years (range, 49-72 years). Duration of diabetes was average 14 years (range, $6{\sim}30$ years), all had type 2 diabetes. Sensation was examined with 5.07 nylon monofilament. The route of purchasing the shoes, compliance to the prescribed shoes were investigated by interview. The shape of shoe, stiffness of upper, conformity of insole to the shape of the foot were recorded. In-shoe plantar pressure was measured in 15 patients. Results: Eighteen patients were insensate to the monofilament. Seven patients did not wear the therapeutic shoes, and only 18 of 35 patients were wearing the therapeutic shoes more than 6 hours a day. The shoes of 17 patients were prescribed by medical doctor and the rest were purchased by the recommendation of acquaintances or advertisement. Ulcer recurred in four of five patients to whom the shoe was prescribed by medical doctor and the cause of three recurrences were evident by just observing the foot and shoe. The therapeutic shoes were made from 11 different makers. Eight shoes were adequate for diabetic patients with respect to the material, shape of insole, type of shoe. In-shoe plantar pressure was examined in 15 patients and was less than 300 kPa in all patients. Conclusion: The therapeutic shoes for the diabetic patients need to be prescribed by medical doctor for selective patients with neuropathy or previous history of ulcer and follow-up examination is important to monitor the compliance of the patients and adequacy of the shoes.

Keywords

References

  1. Burns SL, Leese GP and McMurdo MET: Older people and ill fitting shoes. Postgrad Med J, 78: 344-346, 2002. https://doi.org/10.1136/pmj.78.920.344
  2. Busch K and Chantelau E: Effectiveness of a new brand of stock 'diabetic' shoes to protect against diabetic foot ulcer relapse. A prospective cohort study. Diabet Med, 20:665-669, 2003. https://doi.org/10.1046/j.1464-5491.2003.01003.x
  3. Caputo GM, Cavanagh PR, Ulbrecht JS, Gibbons GW and Karchmer AW: Assessment and management of foot disease in patients with diabetes. N Engl J Med, 331: 854-860, 1994. https://doi.org/10.1056/NEJM199409293311307
  4. Cavanagh PR, Ulbrecht JS and Caputo GM: New developments in the biomechanics of the diabetic foot. Diabetes Metab Res Rev, 16(Suppl 1): S6-S10, 2000. https://doi.org/10.1002/1520-7560(200009/10)16:1+<::AID-DMRR130>3.0.CO;2-Z
  5. Cavanagh PR, Boulton AJ, Sheehan P, Ulbrecht JS, Caputo GM and Armstrong DG: Therapeutic footwear in patients with diabetes. JAMA, 288: 1232-3, 2002. https://doi.org/10.1001/jama.288.10.1231
  6. Dahmen R, Koomen B, Haspels R and Hoeksma AF: Therapeutic footwear for the neuropathic foot. Diabetes Care, 24: 705-709, 2001. https://doi.org/10.2337/diacare.24.4.705
  7. Donaghue VM, Sarnow MR, Giurini JM, Chrzan JS, Habershaw GM and Veves A: Longitudinal in-shoe foot pressure relief achieved by specially designed footwear in high risk diabetic patients. Diabetes Res Clin Pract, 31:109-114, 1996. https://doi.org/10.1016/0168-8227(96)01211-9
  8. Janisse DJ: Pedorthics in the rehabilitation of the foot and ankle. In: Sammarco CJ ed. Rehabilitation of the foot and ankle. 1st ed. Mosby-Year Book Inc: 351-364, 1995.
  9. Kastenbauer T, Sokol G, Auinger M and Irsigler K: Running shoes for relief of plantar pressure in diabetic patients. Diabet Med, 15: 518-522, 1998. https://doi.org/10.1002/(SICI)1096-9136(199806)15:6<518::AID-DIA623>3.0.CO;2-J
  10. Knowles EA and Boulton AJ: Do people with diabetes wear their prescribed footwear? Diabet Med, 13: 1064-1068, 1996. https://doi.org/10.1002/(SICI)1096-9136(199806)15:6<518::AID-DIA623>3.0.CO;2-J
  11. Litzelman DK, Marriott RJ and Vinicor F: The role of footwear in the prevention of foot lesions in patients with NIDDM. Diabetes Care, 20: 156-162, 1997. https://doi.org/10.2337/diacare.20.2.156
  12. Lobmann R, Kayser R, Kasten G, Kluge KK, Neumann W and Lehnert H: Effects of preventative footwear on foot pressure as determined by pedobarography in diabetic patients: a prospective study. Diabet Med, 18: 314-319, 2001. https://doi.org/10.1046/j.1464-5491.2001.00482.x
  13. Maluf KS and Mueller MJ: Comparison of physical activity and cumulative plantar tissue stress among subjects with and without diabetes mellitus and a history of recurrent plantar ulcers. Clin Biomech, 18: 567-575,2003. https://doi.org/10.1016/S0268-0033(03)00118-9
  14. Payne C, Turner D and Miller K: Determinants of plantar pressures in the diabetic foot. J Diabetes Complications, 16: 277-283, 2002. https://doi.org/10.1016/S1056-8727(01)00187-8
  15. Perry JE, Ulbrecht JS, Derr JA and Cavanagh PR: The use of running shoes to reduce plantar pressures in patients who have diabetes. J Bone Joint Surg, 77-A: 1819-1828, 1995 https://doi.org/10.2106/00004623-199512000-00005
  16. Pinzur, MS, Shields, NN, Goelitz, B, et al.: American Orthopaedic Foot and Ankle Society shoe survey of diabetic patients. Foot Ankle Int, 20: 703-707, 1999. https://doi.org/10.1177/107110079902001105
  17. Praet SFE and Louwerens JWK: The influence of shoe design on plantar pressures in neuropathic feet. Diabetes Care, 26: 441-445, 2003. https://doi.org/10.2337/diacare.26.2.441
  18. Reiber GE, Smith DG, Wallace C, et al.: Effect of therapeutic footwear on foot reulceration in patients with diabetes. JAMA, 287: 2552-2558, 2002. https://doi.org/10.1001/jama.287.19.2552
  19. Uccioli L, Faglia E, Monticone G, et al.: Manufactured shoes in the prevention of diabetic foot ulcers. Diabetes Care, 18: 1376-1378, 1995. https://doi.org/10.2337/diacare.18.10.1376