Information de reference pour ce titreAccession Number: | 01445403-200805001-00027.
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Author: | Bus, S. A. 1,*; Valk, G. D. 2; van Deursen, R. W. 3; Armstrong, D. G. 4; Caravaggi, C. 5; Hlavacek, P. 6; Bakker, K. 7; Cavanagh, P. R. 8
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Institution: | (1)Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (2)Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands (3)Research Centre for Clinical Kinaesiology, Department of Physiotherapy, School of Healthcare Studies, Cardiff University, Heath Park, Cardiff, UK (4)Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA (5)Centre for the Study and Treatment of Diabetic Foot Pathology, Abbiategrasso Hospital, Abbiategrasso (Milan), University Vita Salute San Raffaele, Milan, Italy (6)Tomas Bat'a University, Faculty of Technology, Zlin, Czech Republic (7)IWGDF, Heemstede, The Netherlands (8)Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA (*)Correspondence to: Department of Rehabilitation, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands.
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Title: | |
Source: | Diabetes/Metabolism: Research & Reviews. 24 (Supplement 1):S162-S180, May/June 2008.
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Abstract: | Background: Footwear and offloading techniques are commonly used in clinical practice for the prevention and treatment of foot ulcers in diabetes, but the evidence base to support this use is not well known. The goal of this review was to systematically assess the literature and to determine the available evidence on the use of footwear and offloading interventions for ulcer prevention, ulcer treatment, and plantar pressure reduction in the diabetic foot.
Methods: A search was made for reports on the effectiveness of footwear and offloading interventions in preventing or healing foot ulcers or reducing plantar foot pressure in diabetic patients published prior to May 2006. Both controlled and uncontrolled studies were included. Assessment of the methodological quality of studies and data extraction was independently performed by two reviewers. Interventions were assigned into four subcategories: casting, footwear, surgical offloading and other offloading techniques.
Results: Of 1651 articles identified in the baseline search, 21 controlled studies were selected for grading following full text review. Another 108 uncontrolled and cross-sectional studies were examined. The evidence to support the use of footwear and surgical interventions for the prevention of ulceration is meagre. Evidence was found to support the use of total contact casts and other non-removable modalities for treatment of neuropathic plantar ulcers. More studies are needed to support the use of surgical offloading techniques for ulcer healing. Plantar pressure reduction can be achieved by several modalities including casts, walkers, and therapeutic footwear, but the diversity in methods and materials used limits the comparison of study results.
Conclusions: This systematic review provides support for the use of non-removable devices for healing plantar foot ulcers. Furthermore, more high-quality studies are urgently needed to confirm the promising effects found in both controlled and uncontrolled studies of footwear and offloading interventions designed to prevent ulcers, heal ulcers, or reduce plantar pressure. Copyright (C) 2008 John Wiley & Sons, Ltd.
Copyright (C) 2008 John Wiley & Sons, Inc.
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Author Keywords: | diabetes; diabetic foot; ulcer; footwear; offloading; plantar pressure.
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Language: | English.
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Document Type: | REVIEW ARTICLES.
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Journal Subset: | Clinical Medicine.
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ISSN: | 1520-7552
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DOI Number: | https://dx.doi.org/10.1002/dmrr....- ouverture dans une nouvelle fenêtre
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