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At least 91 records · Page 5Linked to original sources
PubMed2001

A CNS-managed diabetes foot-care clinic: a descriptive survey of characteristics and foot-care behaviors of the patient population.

Lower extremity lesions are the primary cause of hospitalization for people with diabetes, resulting in enormous personal and financial costs. This study used a survey designed to describe the characteristics and foot-care behaviors of people with diabetes who attended a clinical nurse specialist managed foot-care clinic. Forty-eight patients who received care at the participating foot-care clinic completed a 21-item multiple-choice questionnaire designed to determine the presence of foot pathology and foot-care behaviors. Most of the patients were between 65 and 74 years of age, had concurrent illnesses, and had four or more primary care visits per year. Although 69% had existing foot pathology, only 44% reported inspecting their feet daily and only 54% reported that their primary care provider examined their feet on each visit. Twenty-five percent reported going barefoot sometimes and eight percent would either treat a foot lesion themselves or wait for it to get better.

Adult↗
PubMed2004

Adaptive control of a variable-impedance ankle-foot orthosis to assist drop-foot gait.

An active ankle-foot orthoses (AAFO) is presented where the impedance of the orthotic joint is modulated throughout the walking cycle to treat drop-foot gait. During controlled plantar flexion, a biomimetic torsional spring control is applied where orthotic joint stiffness is actively adjusted to minimize forefoot collisions with the ground. Throughout late stance, joint impedance is minimized so as not to impede powered plantar flexion movements, and during the swing phase, a torsional spring-damper control lifts the foot to provide toe clearance. To assess the clinical effects of variable-impedance control, kinetic and kinematic gait data were collected on two drop-foot participants wearing the AAFO. For each participant, zero, constant, and variable impedance control strategies were evaluated and the results were compared to the mechanics of three age, weight, and height matched normals. We find that actively adjusting joint impedance reduces the occurrence of slap foot allows greater powered plantar flexion and provides for less kinematic difference during swing when compared to normals. These results indicate that a variable-impedance orthosis may have certain clinical benefits for the treatment of drop-foot gait compared to conventional ankle-foot orthoses having zero or constant stiffness joint behaviors.

Aged↗
PubMed2006

Responsiveness of the foot function index, AOFAS clinical rating systems, and SF-36 after foot and ankle surgery.

BACKGROUND: There is uncertainty regarding which outcomes tools should be used to report the results of treatment for patients with foot and ankle disorders. This study compared the responsiveness of the Foot Function Index (FFI), American Orthopaedic Foot and Ankle Society (AOFAS) Clinical Rating Systems, and Medical Outcomes Study Short Form-36 (SF-36) in patients with foot and ankle surgery. METHODS: Twenty-five patients were recruited at a tertiary referral foot and ankle practice. The mean age of the patient sample was 40 years (range 21 to 69) and 19 were women (76%). Thirteen patients (52%) had conditions affecting the ankle, hindfoot, or midfoot, while 12 patients (48%) had conditions affecting the forefoot. Patients completed packets preoperatively and 6-months postoperatively which included informed consent forms, the FFI, the AOFAS, and the SF-36 questionnaires. Standardized response means (SRM) and effect sizes (ES) were used as the measures of responsiveness and were calculated for the AOFAS scores, the three domains of the FFI, the eight SF-36 sub-scales, and the two SF-36 summary scales. RESULTS: The standardized response mean (SRM) for the AOFAS scores was 1.10 and the effect size (ES) was 1.12. The SRM for the three FFI domains ranged from -0.39 to -0.83, while the ES ranged from -0.55 to -0.86. The SRM for the SF-36 ranged from 0.09 to 0.72 (ES ranged from 0.09 to 0.77) with the highest values occurring with the Bodily Pain sub-scale (SRM 0.72, ES 0.77) and Physical Component Summary scale (SRM 0.76, ES 0.68). CONCLUSIONS: This study demonstrated increased responsiveness of foot and ankle specific outcomes tools compared to the SF-36. However, the Bodily Pain sub-scale and Physical Component Summary scale of the SF-36 had levels of responsiveness approaching those of the FFI and AOFAS Systems after foot and ankle surgery. This suggests that the SF-36 may be used alone to monitor the outcomes in these patients without sacrificing adequate sensitivity to clinical change.

Adult↗
PubMed1996

Foot pathology and risk factors for diabetic foot disease in elderly men.

We examined 3 groups of elderly men; men with diabetes and previous or present foot ulcers, men with diabetes, and men without diabetes. In the foot diseased group, diabetes duration was longer (18 +/- 11 vs 8 +/- 7 years), insulin treatment was more common (86% vs 7%), fasting blood glucose and HbA1c were significantly higher (10.5 +/- 4.0 mmol/1, 8.4% +/- 1.6%) than in the diabetic control group (8.3 +/- 3.4 mmol/l, 7.4 +/- 1.7%). Men in the foot diseased group were taller than men in the diabetic group and non-diabetic men (1.79 vs 1.74 m) but not more obese (BMI 26-27 kg/m2 in all three groups). Current or previous alcoholic problems were more common in the foot diseased group (32%) compared to the control diabetic group (9%) and the non-diabetic group (10%). Diabetic patients with known foot disease had more often callosities, absent hair growth, dry skin and redness, compared to the other groups. Psychosocial problems (alcohol and divorce), long standing diabetes duration and poor metabolic control seem to be of importance for the development of diabetic foot ulcers.

Aged↗
PubMed2001

Effectiveness of the diabetic foot risk classification system of the International Working Group on the Diabetic Foot.

OBJECTIVE: To evaluate the effectiveness of a diabetic foot risk classification system by the International Working Group on the Diabetic Foot to predict clinical outcomes. RESEARCH DESIGN AND METHODS: A total of 225 diabetic patients were initially evaluated as part of a prospective case-control study at the University of Texas Health Science Center at San Antonio. Complete records were available for 213 patients for follow-up evaluation after 29 months. Upon enrollment, subjects were stratified into four risk groups based on the presence of risk factors according to the consensus of the International Working Group on the Diabetic Foot. Group 0 consisted of subjects without neuropathy, group 1 consisted of patients with neuropathy but without deformity or peripheral vascular disease (PVD), group 2 consisted of subjects with neuropathy and deformity or PVD, and group 3 consisted of patients with a history of foot ulceration or a lower-extremity amputation. RESULTS: Upon enrollment, patients in higher-risk groups had longer duration of diabetes, worse glycemic control, vascular and neuropathic variables, and more systemic complications of diabetes. During 3 years of follow-up, ulceration occurred in 5.1, 14.3, 18.8, and 55.8% of the patients in groups 0, 1, 2, and 3, respectively (linear-by-linear association, P < 0.001). All amputations were found in Groups 2 and 3 (3.1 and 20.9%, P < 0.001). CONCLUSIONS: The foot risk classification of the International Working Group on the Diabetic Foot predicts ulceration and amputation and can function as a tool to prevent lower-extremity complications of diabetes.

Blood Pressure↗
PubMed2005

Lengthening procedures of small bones of foot and foot stump.

Foot length discrepancy may result from congenital or acquired causes. If the absence of the foot is more proximal than the metatarsal level, push off and foot resilience will be disturbed and rapid walking and spring will be awkward. Those patients have to be fitted with a prosthesis extending above the ankle to the distal leg. The functional impairment and poor cosmetic appearance become social problems especially for adolescents. Twelve cases underwent a lengthening procedure of small bones of the foot in our clinic since 1995 to lengthen the foot or a foot stump. Results were satisfactory.

Adolescent↗
PubMed2005

Tanita foot-to-foot bioelectrical impedance analysis system validated in older adults.

Simple, accurate, and noninvasive methods for assessing body composition are needed in many clinical, community, and research settings. The foot-to-foot bioelectrical impedance analysis (BIA) system may be one method of addressing those needs. The objective of this study was to determine the validity of a foot-to-foot BIA system for body-composition assessment of older adults. Subjects 55 years of age or older without functional limitations or cognitive impairments (N=50) were measured using both the Tanita foot-to-foot system (Tanita Corporation of America, Inc, Arlington Heights, IL) and traditional hand-to-foot BIA. The correlation for percent body fat measurements between the Tanita and traditional BIA was r=0.84 (P<.001). Percent body fat estimates from both BIA measures were significantly correlated with waist circumference, body mass index, and age (all P<.01). The Tanita BIA system provides a valid measure of percent body fat in older adults, and could be a convenient and practical approach for assessment in public health settings.

Adipose Tissue↗
PubMed1997

The adaptation of the foot to heavy loads: plantar foot pressures study.

INTRODUCTION:: The foot serves as the main shock absorber during various activities as walking running and jumping. There are static and dynamic mechanisms which play a role in the adaptation of the foot to weight bearing walking with weights. The function of the foot while weight bearing was studied mainly under static conditions. We designed an experiment to explore dynamically the adaptation of the foot to weight bearing walking with weights. METHODS:: Ten healthy subjects participated the study. They walked barefoot over an EMED force plate which based on multiple pressure capacitance sensors. Each subject walked three times. The first walk was without any weight, the second walk with weight of 20 kg in backpack and the third walk with weight of 40 kg. Contact area, peak pressures, peak forces and duration of contact time were measured in seven areas of interest of the foot-heel, midfoot, lateral, central and medial forefoot, lateral toes and hallux. RESULTS:: The pressure time integral and force time integral increased in most areas of the foot except for the midfoot in the 20 kg walk. The largest increase was at the central and medial forefoot. Adding additional 20 kg to the load did not increased the loads on the midfoot but increased further the loads mainly at the central and medial forefoot. CONCLUSIONS:: The human foot adapts itself under loading condition by maintaining the medial longitudinal arch. Increasing the loading further activates compensatory mechanisms which maintain the longitudinal arch and shifts the the loads to the central and medial forefoot.

Journal Article↗
PubMed1980

Calcium regulation in clam foot muscle. Calcium sensitivity of clam foot myosin.

1. The ATPase activity of clam foot myosin alone in the presence of 10 mM MgCl2 was activated approximately ten-fold by 10 muM free calcium ions. The calcium activation was observed in various concentrations of KCl (35-600 mM) and ATO (1 muM-1 mM), and at various pHs (pH 6-9.4). 2. The superprecipitation and ATPase activities of clam foot myosin B were studied by conducting experiments in two different ways. In one of these, the ATP concentration was varied at a fixed concentration of MgCl2, and in the other, the MgCl2 concentration was varied at a fixed concentration of ATP. The following was found: (a) The activities responded in a biphasic manner to change in either the ATP or MgCl2 concentration, giving a peak activity around 10 muM ATP or MgCl2. It is thus suggested that Mg-ATP complex is responsible for both activation and inhibition in the biphasic response. (b) When the ATP or MgCl2 concentration was higher than 100-300 muM, practically no superprecipitation occurred in either the presence or absence of calcium, whereas the ATPase activity was still strongly activated by calcium. 3. Similar results to those described above (a, b) were obtained by using rabbit skeletal actoclam foot myosin in place of clam foot myosin B. Moreover, it was found that as the ATP concentration increased from 1 muM to 1 mM, Mg-ATPase activity of clam foot myosin in the presence of calcium increased in a monophasic manner and that it was as active as actomyosin in the presence of calcium when the ATP concentration was higher than approximately 200 muM. In other words, actin-activation of myosin-ATPase was absent in the ATP concentration where no superprecipitation of actomyosin was observed. 4. Clam foot myosin contained two types of light chain subunits: LCl (17,000 daltons) and LC2 (16,000 daltons). Only LC1 was removed upon washing clam myosin with 10 mM EDTA, and removal of LC1 resulted in loss of the calcium sensitivity of actomyosin-ATPase. 5. In our previous report (J. Biochem. 85, 1543-1546, 1979), it was shown that removal of LC1 from clam foot myosin also resulted in loss of the superprecipitation activity of actomyosin reconstituted from "EDTA-washed" myosin. We now provide further evidence that removal of the regulatory light chain (LC1) results in a reversible uncoupling of ATPase reaction from superprecipitation reaction.

Actomyosin↗
PubMed2003

[The effects of a foot-reflexo-massage education program on foot care in diabetic patients].

PURPOSE: This study was conducted to evaluate the effects of foot care education program using foot-reflexo-massage in diabetic patients. METHOD: A convenience sample of non-equivalent control group time series design was used. It provided foot care education to diabetic patients through small book for both group. For the experimental group, foot-reflexo-massage was taught by a researcher and research assistants. Analysis was done by Repeated Measured ANOVA. RESULT: There was significant increase in foot care knowledge, self care behavior, between the experimental group and the control group over three different times. There was significant in skin temperature and pulse of foot over three different times and interaction by groups or over time, but there was no significant difference between groups. There was no significant difference in blood flow volume and capillary filling time over three different times, between groups, but there was interaction by groups or over time. But there was significant difference in discrimination in change of dosalis pedis artery blood flow. CONCLUSION: Findings indicate that this study may contribute to develop nursing intervention for foot care of diabetic patients.

English Abstract↗
PubMedDate not supplied

A three-dimensional, anatomically detailed foot model: a foundation for a finite element simulation and means of quantifying foot-bone position.

We generated an anatomically detailed, three-dimensional (3-D) reconstruction of a human foot from 286 computerized topographic (CT) images. For each bone, 2-D cross-sectional data were obtained and aligned to form a stacked image model. We calculated the inertial matrix of each bone from the stacked image model and used it to determine the principal axes. Relative angles between the principal axes of the bones were employed to describe the shape of the foot, i.e., the relationships between the bones of the foot. A 3-D surface model was generated from the stacked image models and a detailed 3-D mesh for each bone was created. Additionally, the representative geometry of the plantar soft tissue was obtained from the CT scans, while the geometries of the cartilage between bones were obtained from the 3-D surface bone models. This model served dual purposes: it formed the anatomical foundation for a future finite element model of the human foot and we used it to objectively quantify foot shape using the relationships between the principal axes of the foot bones.

Aged↗
PubMed1996

[Diabetic foot syndrome in clinical practice. II. Results after one year at the Diabetic Foot Consulting Unit].

The study included 46 patients with the diabetic foot syndrome and ulcerations, and 40 patients with high-risk foot. Mean duration of hospitalization of the patients with ulcerations was 54 days, mean daily glycemia decreased from 162.5 mg% to 114.9 mg%. Ulcerations were completely healed in 93.5% of patients, whereas high and partial foot amputation was high and 3.2% of patients, respectively. The annual amputation rate was 2.3% in the entire group of diabetic foot patients (86). The present results indicate the necessity for adoption of a multidisciplinary approach to the problem of diabetic foot. It may be added that cooperation in glycemia normalization and patients education may decrease the number of amputations, and hence the degree of physical disability in diabetic foot patients.

Adult↗
PubMed1977

Epidermal-dermal tissue interactions between mutant foot skin and normal back skin: a comparison of the inductive capacities of scaleless low line and normal anterior foot dermis.

The inductive capacities of 9- to 16-day anterior foot dermis of scaleless low line and normal embryos were compared by recombining them with a common source of epidermis, i.e., 7-day normal back epidermis. Tissue recombinants were cultured as grafts to the chorioallantoic membrane (CAM). Both normal and scaleless low line dermis of 12 to 13 days of incubation began to lose their ability to elicit feather production in 7-day normal back epidermis. Normal foot dermis began to elicit scale production at 12 to 13 days, whereas scaleless low line anterior foot dermis maintained feather production at a low level. It is inferred that without being associated with scale placode formation, scaleless low line anterior foot dermis does not acquire specific inductive capacities related to the production of an outer scale surface in the overlying epidermis. Feather placodes do not function as surrogates of scale placodes. The difference between normal and scaleless low line anterior foot dermis in terms of specific inductive capacities related to scale production is interpreted as a secondary effect of the action of the scaleless allele in interfering with scale placode formation in the scaleless low line anterior foot epidermis.

Animals↗
PubMed2005

Blood flow velocity of the femoral vein with foot exercise compared to pneumatic foot compression.

STUDY OBJECTIVE: To compare the effects of foot exercise with an intermittent pneumatic foot compression (IPC) device on blood flow velocity of the femoral veins. DESIGN: Prospective, controlled study. SETTING: General intensive care unit of a university hospital. PATIENTS: 20 patients on bed rest in the intensive care unit. INTERVENTIONS: Patients were divided into 2 groups: group A, foot exercise (n = 10); and group B, IPC device (n = 10). The foot exercise was done once by a nurse for 5 minutes with the dorsiflexion of the ankle (15 times per minute) in group A patients. The IPC device (A-V Impulse System, compression setting: 130 mm Hg for 3 seconds followed by a resting period of 60 seconds) was used for 2 hours in group B. MEASUREMENTS: Peak blood flow velocity of the femoral vein was measured using the ultrasound unit with a 7.5-MHz linear array probe (ALOKA SSD-5500) at 0, 5, 15, 30, 60, and 120 minutes. MAIN RESULTS: Peak blood flow velocities in both groups increased significantly vs the control values during the study. At 5 minutes, group A showed a significant increase in the peak blood flow velocity compared with group B. CONCLUSIONS: Foot exercise by a nurse for 5 minutes was equally or more effective compared with the IPC device in increasing peak blood flow velocity of the femoral vein. The effect of the 5-minute foot exercise lasted for 2 hours.

Aged↗
PubMed1998

One-footed and externally disturbed two-footed postural control in patients with chronic low back pain and healthy control subjects. A controlled study with follow-up.

STUDY DESIGN: A study of postural control during one-footed and externally disturbed two-footed stance among healthy control subjects and patients with chronic low back pain at the beginning of a functional back restoration program and 6 months later at follow-up examination. OBJECTIVES: To study postural control cross-sectionally among control subjects and patients with low back pain, and to evaluate the effects of functional restoration on the postural control parameters in a follow-up examination. SUMMARY OF BACKGROUND DATA: Deficits of motor skills and coordination have been reported in association with musculoskeletal disorders. It has been found that patients with chronic low back pain have impaired psychomotor control, but the impairment is reversible with successful low back rehabilitation. It is insufficiently known how functional activation and intensive physical training affect postural control. METHODS: Sixty-one healthy volunteers (32 men, 29 women) and altogether 99 patients with low back pain participated in the study. Sixty-eight patients (33 men, 35 women) had moderate and 31 (18 men, 13 women) had severe low back pain. Postural stability was measured with a force platform. In two-footed stance, vibration stimulation on calf and back muscles was used to disturb the balance. Center point of force-velocity (cm/sec), average position shift in anteroposterior direction (cm), and maximal position shift in lateral direction (cm) were used as the parameters. RESULTS: Reliability of all tests was acceptable. Center point of force-velocity was the most sensitive parameter and the one-footed measurement the most sensitivetest for evaluating postural stability. At the beginning, the patients with severe low back pain had poorer one-footed postural control compared with the control subjects (P = 0.0003). The subgroup of patients with moderate low back pain participated in the restoration program. The outcome of the restoration program was considered good if the disability because of low back pain (Oswestry index) decreased during the restoration program and poor if the disability increased or did not change. The one-footed postural stability remained primarily at the same level as the initial results in the control and good outcome groups, but became significantly poorer in the poor outcome group. The difference between poor outcome and control groups was statistically significant (P = 0.04). CONCLUSIONS: Impaired postural stability seems to be one factor in multidimensional symptomatology of patients with chronic low back trouble. Postural stability is easily disturbed in case of impairment in strength, coordination, or effective coupling of muscles in the lumbar and pelvic area. Patients with chronic low back pain seem to experience impairment in these functions, which should be taken into consideration when back rehabilitation programs are planned.

Adult↗
PubMed1999

Guidelines for diabetic foot care. The Diabetes Committee of the American Orthopaedic Foot and Ankle Society.

Foot infection is the most common reason for hospital admission of patients with diabetes in the United States. Foot ulceration leads to deep infection, sepsis, and lower extremity amputation. Prophylactic foot care has been shown to decrease patient morbidity, decrease the utilization of expensive resources, and decrease the risk for amputation and premature death. The Diabetes Committee of the American Orthopaedic Foot and Ankle Society has developed guidelines for implementing this type of prophylactic foot care. The guidelines are arranged as follows: I. Screening for Patients Who Are at Risk for Developing Diabetic Foot Complications A. Risk Factors B. Components of Screening and Examination II. Patient Education III. Basic Treatment Guidelines A. Risk Categories B. Nail Care C. Ulcer Care IV. Referral Guidelines A. Vascular Surgery Consultation B. Orthopaedic Consultation C. Endocrinologist/Diabetologist Consultation D. Infectious Disease Consultation E. Radiologic Consultation F. Pedorthic Consultation V. Resources.

Diabetic Foot↗
PubMed1999

Foot flare and foot axis.

Most commercial footwear is designed and manufactured on a curved last, although the amount of curvature of the last and the turning point of the last centerline have not been formally determined. In this study, we used principal component analysis to determine the foot axis so that lasts that match feet can be produced, resulting in a good fit. In evaluating 50 Hong Kong Chinese participants, we found that the center of the foot is located at approximately 52% of the foot length measuring from the back of the foot (SD = 0.65%) and that Hong Kong participants have a mean inflare (inward curvature) of 3.2 degrees. The foot center and inflare measures will help determine the fit between footwear and feet. Applications of this research include the ability to incorporate foot flare into the design and manufacture of footwear.

Adolescent↗
PubMed2000

Tamale foot: deposit of acid mucopolysaccharides in the synovial sheaths of extensor tendons of the foot, resembling tendinitis, in a patient with juvenile ankylosing spondylitis.

We describe a clinical case of juvenile ankylosing spondylitis (AS) that developed "pseudo-chronic tendinitis" of the foot. A 20-year-old male patient had HLA-B27 positive juvenile AS since he was 13 years old. At the age of 19 he presented chronic pain in the dorsum of the left foot. Examination disclosed an increased volume of the tarsal dorsum, with rubbery consistency, with no evidence of venous or lymphatic insufficiency, godette, or inflammation in laboratory tests, giving the foot the appearance of a tamale. Synovectomy of the foot extensor tendon sheath was followed by relief of pain and swelling. Histopathological study showed a deposit of acid mucopolysaccharides (MPS) with no inflammatory cell infiltrate. Tamale foot in juvenile AS may develop as a consequence of acid MPS deposit with no evidence of synovial inflammation. The good response to synovectomy suggests this is the preferred treatment for tamale foot.

Adolescent↗