Biofeedback for foot offloading in diabetic patients with peripheral neuropathy

Pataky, Zoltan; Rodríguez, Diego de León; Allet, Lara; Golay, Alain; Assal, Mathieu; Assal, Jean‐Philippe; Hauert, Claude-Alain

doi:10.1111/j.1464-5491.2009.02875.x

Cited by 45 publications

(88 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies do not describe the foot rollover changes after such a specific set of exercises for foot and ankle [24-27]. Usually, attention is mostly given to PP and PTI reduction as a target to reduce the risk of ulceration, but these variables should be analyzed together with several other risk factors [4,5,36].…”

Section: Discussionmentioning

confidence: 99%

“…Few authors have described the subtle, positive effects of foot and ankle exercises in this population, although some studies were not randomized controlled trials [24,25], and others reported on quite short interventions and follow-up periods [26,27]. Therefore, there are still not enough data for conclusions to be arrived at regarding the effectiveness of such interventions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial

Sartor

Hasue

Cacciari

et al. 2014

BMC Musculoskelet Disord

118

185

View full text Add to dashboard Cite

BackgroundFoot musculoskeletal deficits are seldom addressed by preventive medicine despite their high prevalence in patients with diabetic polyneuropathy.AIM: To investigate the effects of strengthening, stretching, and functional training on foot rollover process during gait.MethodsA two-arm parallel-group randomized controlled trial with a blinded assessor was designed. Fifty-five patients diagnosed with diabetic polyneuropathy, 45 to 65 years-old were recruited. Exercises for foot-ankle and gait training were administered twice a week, for 12 weeks, to 26 patients assigned to the intervention group, while 29 patients assigned to control group received recommended standard medical care: pharmacological treatment for diabetes and foot care instructions. Both groups were assessed after 12 weeks, and the intervention group at follow-up (24 weeks). Primary outcomes involved foot rollover changes during gait, including peak pressure (PP). Secondary outcomes involved time-to-peak pressure (TPP) and pressure–time integral (PTI) in six foot-areas, mean center of pressure (COP) velocity, ankle kinematics and kinetics in the sagittal plane, intrinsic and extrinsic muscle function, and functional tests of foot and ankle.ResultsEven though the intervention group primary outcome (PP) showed a not statistically significant change under the six foot areas, intention-to-treat comparisons yielded softening of heel strike (delayed heel TPP, p=.03), better eccentric control of forefoot contact (decrease in ankle extensor moment, p<.01; increase in function of ankle dorsiflexion, p<.05), earlier lateral forefoot contact with respect to medial forefoot (TPP anticipation, p<.01), and increased participation of hallux (increased PP and PTI, p=.03) and toes (increase in PTI, medium effect size). A slower COP mean velocity (p=.05), and an increase in overall foot and ankle function (p<.05) were also observed. In most cases, the values returned to baseline after the follow-up (p<.05).ConclusionsIntervention discreetly changed foot rollover towards a more physiological process, supported by improved plantar pressure distribution and better functional condition of the foot ankle complex. Continuous monitoring of the foot status and patient education are necessary, and can contribute to preserving the integrity of foot muscles and joints impaired by polyneuropathy.Trial registrationClinicalTrials.gov Identifier: NCT01207284, registered in 20th September 2010.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial

Sartor

Hasue

Cacciari

et al. 2014

BMC Musculoskelet Disord

118

185

View full text Add to dashboard Cite

show abstract

“…In this idea, researches evaluating the effect of ''psychological interventions'' exclude the ''education'' and compare different psychological interventions to control groups, these latter being a melting pot that can contain ''waiting list'' as well as ''education'' [8]! For us, a complex intervention aiming to the patient's learning includes all known ways of proven, effective education processes, including providing information, psychological interventions such as Cognitive and Behavioral Therapies (CBT), a process known as behavioral education in education science, and many others such as bio-feedback [42,43].…”

Section: Efficacy Underestimatedmentioning

confidence: 99%

Efficacy of therapeutic patient education in chronic diseases and obesity

Lagger

Pataky

Golay

2010

Patient Education and Counseling

152

View full text Add to dashboard Cite

“…Presence of sensitivity dysfunction is the main symptom of diabetic polyneuropathy-loss of peripheral nerve fiber function-considered the most common predictor of diabetic foot ulceration and symptom associated with a lack of metabolic control of the patient [29]. This result indicates that HbA 1c could also be investigated as a likely marker of risk of diabetic neuropathy-Necessary condition for the appearance of ulcers in Type 2 DM patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical Parameters of Metabolic Control (HbA<sub>1c</sub>) and Deterioration of Peripheral Arterial Perfusion in Type 2 Diabetes

Zúñiga-Martínez¹,

Terán-Figueroa²,

Guerrero-Cruz³

et al. 2017

JDM

View full text Add to dashboard Cite

Objective: To determine the relationship between clinical parameters (HbA 1c ) whit metabolic control and deterioration of peripheral arterial perfusion in diabetic patients. Methodology: 108 medical records of patients with type 2 diabetes mellitus were evaluated. We obtained averages of: blood glucose (162.3 ± 73.10 mg/dl), glycated hemoglobin (HbA 1c = 7.64% ± 1.77%), cholesterol (189.28 ± 35.25 mg/dl), triglycerides (189.11 ± 87.76 mg/dl), Systolic Blood Pressure (SBP = 119.69 ± 14.95 mmHg), Diastolic Blood Pressure (DBP = 77.15 ± 9.55 mmHg) and Media Blood Pressure (MBP = 91.36 ± 9.89 mmHg). We correlated variable HbA 1c with vascular injury symptomatology. Results: Correlation was found between sensitivity dysfunction and HbA 1c with a statistical significance of p = 0.01, and a correlation Kendal coefficient w = 0.01, any other parameter of metabolic control was not correlated with symptoms of vascular injury. Conclusion: It is remarkable that the sensitivity dysfunction is a symptom of poorly vascularized lower extremities caused for both functional impairment and structural changes in diabetic patients' peripheral nerves, even in the preclinical stage of vascular disease. The HbA 1c could also be investigated as a likely sensitivity dysfunction biomarker in DM due to the correlation presented in this study but more studies must be realized.

show abstract

Biofeedback for foot offloading in diabetic patients with peripheral neuropathy

Abstract: Terminal augmented feedback training may positively affect motor learning in diabetic patients with peripheral neuropathy and could possibly lead to suitable foot offloading. Additional research is needed to confirm the maintenance of offloading in the long term.

Cited by 45 publications

References 20 publications

Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial

Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial

Efficacy of therapeutic patient education in chronic diseases and obesity

Clinical Parameters of Metabolic Control (HbA<sub>1c</sub>) and Deterioration of Peripheral Arterial Perfusion in Type 2 Diabetes

Contact Info

Product

Resources

About

Biofeedback for foot offloading in diabetic patients with peripheral neuropathy

Abstract: Terminal augmented feedback training may positively affect motor learning in diabetic patients with peripheral neuropathy and could possibly lead to suitable foot offloading. Additional research is needed to confirm the maintenance of offloading in the long term.

Cited by 45 publications

References 20 publications

Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial

Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial

Efficacy of therapeutic patient education in chronic diseases and obesity

Clinical Parameters of Metabolic Control (HbA&lt;sub&gt;1c&lt;/sub&gt;) and Deterioration of Peripheral Arterial Perfusion in Type 2 Diabetes

Contact Info

Product

Resources

About

Clinical Parameters of Metabolic Control (HbA<sub>1c</sub>) and Deterioration of Peripheral Arterial Perfusion in Type 2 Diabetes