In-shoe pressure thresholds for people with diabetes and neuropathy at risk of ulceration: A systematic review

Jones, Philip C.; Davies, Melanie J.; Khunti, Kamlesh; Fong, Daniel Tik-Pui

doi:10.1016/j.jdiacomp.2020.107815

Cited by 11 publications

(14 citation statements)

References 53 publications

(160 reference statements)

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“…To overcome this difficulty, REM and SMD are used to combine effectors. In REM mode, the SMD between control and experimental groups was calculated for meta-analysis [64,65], which makes it easy for us to perform a quantitative analysis of the study results [28].…”

Section: Discussionmentioning

confidence: 99%

“…Traditional conservative treatment includes plaster cast or splint fixation, while available conservative treatment includes bandage, tape, different stents, and balance training [27]. Traditional Chinese medicine is widely used in Korean medicine to treat pain and swelling caused by ankle sprain [28,29]. At present, exercise therapy is the most widely used and standard treatment.…”

Section: Introductionmentioning

confidence: 99%

“…They are currently studying singletreatment effects, and the quality of products is uneven. The range of wearable development tools currently available is expanding [28]. Therefore, more research is needed to consider many aspects of wearable devices, including comfort, ergonomics, material quality, and aesthetics [45].…”

Section: Introductionmentioning

confidence: 99%

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The applications of wearable devices in the rehabilitation of ankle injuries: A systematic review and meta-analysis

Wang

Qiu

Fong

2023

Medicine in Novel Technology and Devices

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The applications of wearable devices in the rehabilitation of ankle injuries: A systematic review and meta-analysis

Wang

Qiu

Fong

2023

Medicine in Novel Technology and Devices

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“…However, a larger study incorporating an objective and accurate measure of adherence is needed to explore this further. For example, Bus et al [8] utilised an in-shoe temperature monitor combined with a step activity monitor around the ankle. Alternatively, dual accelerometers worn on the body and attached to the shoe can provide an objective measure of adherence [23].…”

Section: Adherence To Medical Grade Footwearmentioning

confidence: 99%

Does in‐shoe pressure analysis to assess and modify medical grade footwear improve patient adherence and understanding? A mixed methods study

McDonogh

Nubé

Frank

et al. 2022

Journal of Foot and Ankle Research

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Background Medical grade footwear (MGF) with demonstrated plantar-pressure reducing effect is recommended to reduce the risk of diabetes-related foot ulceration (DFU). Efficacy of MGF relies on high adherence (≥ 80%). In-shoe pressure analysis (IPA) is used to assess and modify MGF, however, there is limited evidence for the impact on patient adherence and understanding of MGF. The primary aim of this study was to determine if self-reported adherence to MGF usage in patients with previous DFU improved following IPA compared to adherence measured prior. The secondary aim was to determine if patient understanding of MGF improved following in-shoe pressure analysis. Methods Patients with previous DFU fitted with MGF in the last 12 months were recruited. The first three participants were included in a pilot study to test procedures and questionnaires. MGF was assessed and modified at Week 0 based on findings from IPA using the Pedar system (Novel). Patients completed two questionnaires, one assessing patient adherence to MGF at Week 0 and Week 4, the other assessing patient understanding of MGF before and after IPA at week 0. Patient understanding was measured using a 5-point Likert scale (strongly disagree 1 to strongly agree 5). Patient experience was assessed via a telephone questionnaire administered between Weeks 0–1. Results Fifteen participants were recruited, and all completed the study. Adherence of ≥ 80% to MGF usage inside the home was 13.3% (n = 2) pre-IPA and 20.0% (n = 3) at Week 4. Outside the home, ≥ 80% adherence to MGF was 53.3% (n = 8) pre-IPA, and 80.0% (n = 12) at Week 4. Change in scores for understanding of MGF were small, however, all participants reported that undergoing the intervention was worthwhile and beneficial. Conclusions Self-reported adherence inside the home demonstrated minimal improvement after 4 weeks, however, adherence of ≥ 80% outside the home increased by 27%, with 80% of all participants reporting high adherence at Week 4. Participants rated their learnings from the experience of IPA as beneficial.

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“…Current national and international guidelines provide a strong recommendation for patients with a history of DFU to be tted with MGF that demonstrates plantar pressure reducing capacity to reduce the risk of foot ulcer recurrence (3,4,7). O oading e cacy has been de ned as an MPP measurement below 200kPa at the site(s) of previous ulceration (8), and this remains the most commonly used target to reduce the risk of re-ulceration in this population (9).…”

mentioning

confidence: 99%

In-shoe pressure analysis in patients with a history of diabetes-related foot ulceration: a mixed methods study

McDonogh

Nubé

Frank

et al. 2022

Preprint

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Background Medical grade footwear (MGF) with demonstrated plantar-pressure reducing effect is recommended to reduce the risk of diabetes-related foot ulceration (DFU). Efficacy of MGF relies on high adherence (≥ 80%). In-shoe pressure analysis (IPA) is used to assess and modify MGF, however, there is limited evidence for the impact on patient adherence and understanding of MGF. The primary aim of this study was to determine if self-reported adherence to MGF usage in patients with previous DFU improved following IPA compared to adherence measured prior. The secondary aim was to determine if patient understanding of MGF improved following in-shoe pressure analysis. Methods Patients with previous DFU fitted with MGF in the last 12 months were recruited. The first three participants were included in a pilot study to test procedures and questionnaires. MGF was assessed and modified at Week 0 based on findings from IPA using the Pedar system (Novel). Patients completed two questionnaires, one assessing patient adherence to MGF at Week 0 and Week 4, the other assessing patient understanding of MGF before and after IPA at week 0. Patient understanding was measured using a 5-point Likert scale (strongly disagree 1 to strongly agree 5). Patient experience was assessed via a telephone questionnaire administered between Weeks 0–1. Results 15 participants were recruited, and all completed the study. Adherence of ≥ 80% to MGF usage inside the home was n = 2 (13.3%) pre-IPA and n = 3 (20.0%) at Week 4. Outside the home, ≥ 80% adherence to MGF was n = 8 (53.3%) pre-IPA, and n = 12 (80.0%) at Week 4. All participants reported that undergoing IPA improved their understanding of the value of MGF and that undergoing the intervention was worthwhile and beneficial. Conclusions Self-reported adherence inside the home demonstrated minimal improvement after 4 weeks, however, adherence of ≥ 80% outside the home increased by 27%, with 80% of all participants reporting high adherence at Week 4. Participants rated their learnings from the experience of IPA as beneficial.

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In-shoe pressure thresholds for people with diabetes and neuropathy at risk of ulceration: A systematic review

Cited by 11 publications

References 53 publications

The applications of wearable devices in the rehabilitation of ankle injuries: A systematic review and meta-analysis

The applications of wearable devices in the rehabilitation of ankle injuries: A systematic review and meta-analysis

Does in‐shoe pressure analysis to assess and modify medical grade footwear improve patient adherence and understanding? A mixed methods study

In-shoe pressure analysis in patients with a history of diabetes-related foot ulceration: a mixed methods study

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