TY - JOUR
T1 - Therapeutic footwear
T2 - Enhanced function in people with diabetes and transmetatarsal amputation
AU - Mueller, Michael J.
AU - Strube, Michael J.
N1 - Funding Information:
From the Program in Physical Therapy, (Dr. Mueller), Washington University School of Medicine and the Department of Psychology (Dr. Strobe), Wahington University, St. Louis, MO. Submitted for publication September 27, 1996. Accepted in revised from January 29, 1997. Supported by National Institutes of Health grant HD 3 1486.01, National Center for Medical Rehabilitation Research. No commercial party having a direct financial interest in the results of the revearch wpporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated. Reprint requests to Michael J. Mueller, PhD, PT. Assistant Professor, Program in Physical Therapy, Washington University School of Medicine, Box 8502, 4444 Forest Park Boulevard, St. Louis, MO 63 108. 0 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation 0003-9993/97/7809-4203$3.00/O
PY - 1997/9
Y1 - 1997/9
N2 - Objective: Patients with diabetes mellitus (DM) and a transmetatarsal amputation (TMA) have considerable deficits in function compared with age- matched controls. The purpose of this study was to determine if therapeutic footwear could improve the functional mobility of patients with DM and TMA. Study Design: Repeated-measures design. Setting: Academic medical center. Patients: Thirty subjects (10 women, 20 men) with DM and a TMA, with a mean age of 61.7 ± 4.0yrs. Interventions: Six types of footwear evaluating the following components: length of shoe (full-length or short shoe), a rigid rocker-bottom sole, and an ankle-foot-orthosis. Outcome Measures: Physical Performance Test (PPT), functional reach, and walking speed. Measurements in each footwear condition occurred after a 1-month adjustment period. Results: Patients wearing full-length custom-made shoes with a total-contact insert, a rigid rocker-bottom sole or a short shoe with a rigid rocker-bottom sole (with or without an ankle-foot-orthosis) had similar and significantly higher scores in the Plat and faster walking speed than when wearing regular shoes with a toe filler (p < .05). The short shoe and the ankle-foot-orthosis, however, generated many patient complaints about cosmesis and restriction at the ankle, respectively. There were no differences in any of the measures of functional reach. Conclusion: Although there are individual exceptions, we recommend the full-length shoe, total-contact insert, and a rigid rocker- bottom sole for most patients with DM and a TMA.
AB - Objective: Patients with diabetes mellitus (DM) and a transmetatarsal amputation (TMA) have considerable deficits in function compared with age- matched controls. The purpose of this study was to determine if therapeutic footwear could improve the functional mobility of patients with DM and TMA. Study Design: Repeated-measures design. Setting: Academic medical center. Patients: Thirty subjects (10 women, 20 men) with DM and a TMA, with a mean age of 61.7 ± 4.0yrs. Interventions: Six types of footwear evaluating the following components: length of shoe (full-length or short shoe), a rigid rocker-bottom sole, and an ankle-foot-orthosis. Outcome Measures: Physical Performance Test (PPT), functional reach, and walking speed. Measurements in each footwear condition occurred after a 1-month adjustment period. Results: Patients wearing full-length custom-made shoes with a total-contact insert, a rigid rocker-bottom sole or a short shoe with a rigid rocker-bottom sole (with or without an ankle-foot-orthosis) had similar and significantly higher scores in the Plat and faster walking speed than when wearing regular shoes with a toe filler (p < .05). The short shoe and the ankle-foot-orthosis, however, generated many patient complaints about cosmesis and restriction at the ankle, respectively. There were no differences in any of the measures of functional reach. Conclusion: Although there are individual exceptions, we recommend the full-length shoe, total-contact insert, and a rigid rocker- bottom sole for most patients with DM and a TMA.
UR - http://www.scopus.com/inward/record.url?scp=0030883348&partnerID=8YFLogxK
U2 - 10.1016/S0003-9993(97)90056-3
DO - 10.1016/S0003-9993(97)90056-3
M3 - Article
C2 - 9305267
AN - SCOPUS:0030883348
VL - 78
SP - 952
EP - 956
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 9
ER -