Efficacy of customized insoles in the improvement of plantar pressure in patients with diabetic neuropathy: Protocol of a randomized and controlled clinical trial

Authors

  • Gabriel Farhat Ponta Grossa State University (Ponta Grossa), Paraná, Brazil. https://orcid.org/0000-0002-1790-2540
  • Camila Marinelli Martins Ponta Grossa State University (Ponta Grossa), Paraná, Brazil.
  • Ricardo Zanetti Gomes Ponta Grossa State University (Ponta Grossa), Paraná, Brazil. https://orcid.org/0000-0002-9651-8298
  • Letícia Carollyne Galvão Ponta Grossa State University (Ponta Grossa), Paraná, Brazil.
  • Rodolfo Martins Kravutschke Ponta Grossa State University (Ponta Grossa), Paraná, Brazil.
  • Fabiana Bucholdz Teixeira Alves Ponta Grossa State University (Ponta Grossa), Paraná, Brazil.

DOI:

https://doi.org/10.17267/2238-2704rpf.v11i4.3904

Keywords:

Diabetic neuropathies, Dynamic orthoses, Plantar callosity

Abstract

OBJECTIVE: To evaluate the influence of customized insoles in the plantar pressure of diabetes patients with neuropathy in comparison to the sham group. METHODS:  The work method, duly registered at the Registro Brasileiro de Ensaios Clínicos – REBEC (Clinical Trial Brazilian Register) (http://www.ensaiosclinicos.gov.br/) RBR-5NQK4K, includes a randomized, controlled, prospective, double-blinded clinical trial, with a sample of 46 volunteers that will be randomly randomized in a 1: 1 ratio to be referred to intervention and control groups. The intervention group will receive customized insoles, with a retrocapital bar and an ethyl vinyl acetate plaque (EVA) in the same shape as the retrocapital bar, in order to reduce the pressure on the forefoot. In the control group, flat insoles will be prepared without any therapeutic objective. This project was developed according to the standard protocol for randomized clinical trials (SPIRIT). Along with the clinical evaluation, demographic data of the sample will be collected to identify and confirm the presence of peripheral neuropathy, next, the pedobarographic will be evaluated, and finally, the patients will answer the FAAM questionnaire to assess foot functionality. The primary outcome will be analyzing pressure points in KiloPascal (kPa) in the patients’ feet through pedobarographic of the patients in the intervention and control groups. The secondary outcome will be the foot functionality in activities of daily living through the FAAM (Foot and Ankle Ability Measure), considering the volunteers in the initial evaluation, third and sixth months.  FINAL CONSIDERATIONS: Mainly, results of this study will show whether there is a structural alteration in the analysis of the plantar pressure due to the continuous use of insoles and present the evaluation of whether the use of therapeutic insoles improves the foot functionality of the same users when compared to sham insoles.

Downloads

Download data is not yet available.

References

Cho NH, Shaw JE, Karuranga S, Huang Y, Fernandes JDR, Ohlrogge AW, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271–81. https://doi.org/10.1016/j.diabres.2018.02.023

Oliveira JEP, Montenegro Junior RM, Vencio S, organizers. Diretrizes da Sociedade Brasileira de Diabetes 2017-2018 [Internet]. São Paulo: Clannad; 2017. Available from: https://edisciplinas.usp.br/pluginfile.php/4232401/mod_resource/content/2/diretrizes-sbd-2017-2018%281%29.pdf

American Diabetes Association AD. Economic costs of diabetes in the US in 2012. Diabetes Care. 2013;36(4):1033–46. https://doi.org/10.2337/dc12-2625

American Diabetes Association AD. Standards of Medical Care in Diabetes-2017 Abridged for Primary Care Providers. Clin Diabetes. 2017;35(1):5–26. https://doi.org/10.2337/cd16-0067

Skyler JS, Bakris GL, Bonifacio E, Darsow T, Eckel RH, Groop L, et al. Differentiation of Diabetes by Pathophysiology, Natural History, and Prognosis. Diabetes. 2017;66(2):241–55. https://doi.org/10.2337/db16-0806

Kahn SE, Cooper ME, Del Prato S. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. Lancet. 2014;383(9922):1068–83. https://doi.org/10.1016/s0140-6736(13)62154-6

Sinaiko AR, Steinberger J, Moran A, Prineas RJ, Vessby B, Basu S, et al. Relation of body mass index and insulin resistance to cardiovascular risk factors, inflammatory factors, and oxidative stress during adolescence. Circulation. 2005;111(15):1985–91. https://doi.org/10.1161/01.cir.0000161837.23846.57

Foss-Freitas MC, Marques Junior W, Foss MC. Neuropatia autonômica: uma complicação de alto risco no diabetes melito tipo 1. Arq Bras Endocrinol Metabol. 2008;52(2):398–406. https://doi.org/10.1590/S0004-27302008000200028

Juster-Switlyk K, Smith AG. Updates in diabetic peripheral neuropathy. F1000Research. 2016;5:738. https://dx.doi.org/10.12688%2Ff1000research.7898.1

Chuan F, Tang K, Jiang P, Zhou B, He X. Reliability and validity of the perfusion, extent, depth, infection and sensation (PEDIS) classification system and score in patients with diabetic foot ulcer. PLoS One. 2015;10(4):e0124739. https://doi.org/10.1371/journal.pone.0124739

Nascimento OJM, Pupe CCB, Cavalcanti EBU. Diabetic neuropathy. Rev Dor. 2016;17(suppl 1):46–51. https://doi.org/10.5935/1806-0013.20160047

Skopljak A, Sukalo A, BaticMujanovic O, Becirevic M, TiricCampara M, Zunic L. Assessment of Diabetic Polyneuropathy and Plantar Pressure in Patients with Diabetes Mellitus in Prevention of Diabetic Foot. Med Arch. 2014;68(6):389. https://doi.org/10.5455/medarh.2014.68.389-393

Gurney JK, Kersting UG, Rosenbaum D, Dissanayake A, York S, Grech R, et al. Pedobarography as a clinical tool in the management of diabetic feet in New Zealand: a feasibility study. J Foot Ankle Res. 2017;10:24. https://doi.org/10.1186/s13047-017-0205-6

Hellstrand Tang U, Zügner R, Lisovskaja V, Karlsson J, Hagberg K, Tranberg R. Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers - A two-year, randomized trial. J Clin Transl Endocrinol. 2014;1(4):121–32. https://doi.org/10.1016/j.jcte.2014.06.002

Paton JS, Stenhouse EA, Bruce G, Zahra D, Jones RB. A comparison of customised and prefabricated insoles to reduce risk factors for neuropathic diabetic foot ulceration: A participant-blinded randomised controlled trial. J Foot Ankle Res. 2012;5(1):31. https://doi.org/10.1186/1757-1146-5-31

Rizzo L, Tedeschi A, Fallani E, Coppelli A, Vallini V, Iacopi E, et al. Custom-made orthesis and shoes in a structured follow-up program reduces the incidence of neuropathic ulcers in high-risk diabetic foot patients. Int J Low Extrem Wounds. 2012;11(1):59?64. https://doi.org/10.1177/1534734612438729

Bus SA, van Deursen RW, Armstrong DG, Lewis JEA, Caravaggi CF, Cavanagh PR. Footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in patients with diabetes: a systematic review. Diabetes Metab Res Rev. 2016;32(suppl 1):99–118. https://doi.org/10.1002/dmrr.2702

El-Hilaly R, Elshazly O, Amer A. The role of a total contact insole in diminishing foot pressures following partial first ray amputation in diabetic patients. Foot. 2013;23(1):6–10. https://doi.org/10.1016/j.foot.2012.10.002

Martin RL, Irrgang JJ, Burdett RG, Conti SF, Swearingen JM Van. Evidence of Validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int. 2005;26(11):968–83. https://doi.org/10.1177/107110070502601113

Moreira TS, Magalhães LC, Silva RD, Martin RL, Resende MA. Translation, cross-cultural adaptation and validity of the Brazilian version of the Foot and Ankle Ability Measure questionnaire. Disabil Rehabil. 2016;38(25):2479–90. https://doi.org/10.3109/09638288.2015.1137979

McCoy CE. Understanding the intention-to-treat principle in randomized controlled trials. West J Emerg Med. 2017;18(6):1075–8. https://dx.doi.org/10.5811%2Fwestjem.2017.8.35985

Bacarin TA, Sacco ICN, Hennig EM. Plantar pressure distribution patterns during gait in diabetic neuropathy patients with a history of foot ulcers. Clinics. 2009;64(2):113-20. https://doi.org/10.1590/s1807-59322009000200008

Oliveira G, Greve J, Imamura M, Bolliger R, Oliveira G, Bolliger Nt R. Interpretação das variáveis quantitativas da baropodometria computadorizada em indivíduos normais. Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo [Internet]. 1998;53(1):16-20. Available from: https://www.scienceopen.com/document?vid=3cf585bf-afc6-4a2b-b85d-0a93061789f3

Tuna H, Yildiz M, Celtik C, Kokino S. [Static and dynamic plantar pressure measurements in adolescents]. Acta Orthop Traumatol Turc. 2004;38(3):200–5. Cited: PMID: 15347920.

Walsh JW, Hoffstad OJ, Sullivan MO, Margolis DJ. Association of diabetic foot ulcer and death in a population-based cohort from the United Kingdom. Diabet Med. 2016;33(11):1493–8. https://doi.org/10.1111/dme.13054

Peixoto JG, Dias AG, Miranda LM, Defilipo ÉC, Feitosa MB, Chagas PSC. Reliability analysis of static and dynamic plantar pressure measurements of children and youths with normal development. Fisioter e Pesqui. 2017;24(1):46–53. https://doi.org/10.1590/1809-2950/16222224012017

Published

09/27/2021

Issue

Section

Methods & Protocols

How to Cite

1.
Farhat G, Martins CM, Gomes RZ, Galvão LC, Kravutschke RM, Teixeira Alves FB. Efficacy of customized insoles in the improvement of plantar pressure in patients with diabetic neuropathy: Protocol of a randomized and controlled clinical trial. Rev Pesq Fisio [Internet]. 2021 Sep. 27 [cited 2024 Dec. 22];11(4):815-22. Available from: https://www5.bahiana.edu.br/index.php/fisioterapia/article/view/3904

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>