Footwear and insole design features for offloading the diabetic at risk foot - A Systematic Review and Meta-Analyses
dc.contributor.author | Collings, Richard | |
dc.contributor.author | Freeman, Jennifer | |
dc.contributor.author | Latour, Jos M | |
dc.contributor.author | Paton, Joanne | |
dc.date.accessioned | 2020-03-21T17:49:04Z | |
dc.date.issued | 2020-04-11 | |
dc.identifier.issn | 2052-0573 | |
dc.identifier.issn | 2398-9238 | |
dc.identifier.uri | http://hdl.handle.net/10026.1/15467 | |
dc.description.abstract |
<jats:title>Abstract</jats:title><jats:p>The aim of this systematic review was to identify the best footwear and insole design features for offloading the plantar surface of the foot to prevent foot ulceration in people with diabetic peripheral neuropathy. We searched multiple databases for published and unpublished studies reporting offloading footwear and insoles for people with diabetic neuropathy and nonulcerated feet. Primary outcome was foot ulcer incidence; other outcome measures considered were any standardized kinetic or kinematic measure indicating loading or offloading the plantar foot. Fifty‐four studies, including randomized controlled studies, cohort studies, case‐series, and a case‐controlled and cross‐sectional study were included. Three meta‐analyses were conducted and random‐effects modelling found peak plantar pressure reduction of arch profile (37 kPa (MD, −37.5; 95% CI, −72.29 to −3.61; <jats:italic>P</jats:italic> < .03), metatarsal addition (35.96 kPa (MD, −35.96; 95% CI, −57.33 to −14.60; <jats:italic>P</jats:italic> < .001) and pressure informed design 75.4 kPa (MD, −75.4 kPa; 95% CI, −127.4 to −23.44 kPa; <jats:italic>P</jats:italic> < .004).The remaining data were presented in a narrative form due to heterogeneity. This review highlights the difficulty in differentiating the effect of different insole and footwear features in offloading the neuropathic diabetic foot. However, arch profiles, metatarsal additions and apertures are effective in reducing plantar pressure. The use of pressure analysis to enhance the effectiveness of the design of footwear and insoles, particularly through modification, is recommended.</jats:p> | |
dc.format.extent | e00132- | |
dc.format.medium | Electronic-eCollection | |
dc.language | en | |
dc.language.iso | en | |
dc.publisher | BioScientifica | |
dc.subject | diabetic foot | |
dc.subject | footwear | |
dc.subject | insoles | |
dc.subject | offloading | |
dc.subject | prevention | |
dc.subject | systematic review | |
dc.subject | Diabetic Foot | |
dc.subject | Diabetic Nephropathies | |
dc.subject | Equipment Design | |
dc.subject | Foot Orthoses | |
dc.subject | Humans | |
dc.subject | Shoes | |
dc.subject | Treatment Outcome | |
dc.title | Footwear and insole design features for offloading the diabetic at risk foot - A Systematic Review and Meta-Analyses | |
dc.type | journal-article | |
dc.type | Journal Article | |
dc.type | Meta-Analysis | |
dc.type | Research Support, Non-U.S. Gov't | |
dc.type | Review | |
dc.type | Systematic Review | |
plymouth.author-url | https://www.ncbi.nlm.nih.gov/pubmed/33532602 | |
plymouth.issue | 1 | |
plymouth.volume | 4 | |
plymouth.publication-status | Published | |
plymouth.journal | Endocrinology, Diabetes and Metabolism | |
dc.identifier.doi | 10.1002/edm2.132 | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Health | |
plymouth.organisational-group | /Plymouth/Faculty of Health/School of Health Professions | |
plymouth.organisational-group | /Plymouth/Faculty of Health/School of Nursing and Midwifery | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy | |
plymouth.organisational-group | /Plymouth/Research Groups | |
plymouth.organisational-group | /Plymouth/Research Groups/Institute of Health and Community | |
plymouth.organisational-group | /Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR) | |
plymouth.organisational-group | /Plymouth/Users by role | |
plymouth.organisational-group | /Plymouth/Users by role/Academics | |
plymouth.organisational-group | /Plymouth/Users by role/Researchers in ResearchFish submission | |
dc.publisher.place | England | |
dcterms.dateAccepted | 2020-03-17 | |
dc.rights.embargodate | 2020-4-21 | |
dc.identifier.eissn | 2398-9238 | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1002/edm2.132 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2020-04-11 | |
rioxxterms.type | Journal Article/Review | |
plymouth.funder | Reducing Foot Plantar Pressure (ReFPres) in people with diabetes using an instant insole solution: a mixed methods pilot study::National Institute of Health and Medical Research | |
plymouth.funder | Reducing Foot Plantar Pressure (ReFPres) in people with diabetes using an instant insole solution: a mixed methods pilot study::National Institute of Health and Medical Research |