Foot Assessment in People With Diabetes: A Quantitative Diagnostic Approach

NCT ID: NCT03089463

Last Updated: 2023-04-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

SUSPENDED

Total Enrollment

153 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-11-27

Study Completion Date

2025-01-30

Brief Summary

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This observational cohort study aims to develop a novel risk stratification system implementing biomechanics to aid in the prevention of diabetic foot ulcers.

Detailed Description

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The purpose of this research observational cohort study is to investigate the applicability of using biomechanical assessment in predicting the ulceration incidence in patients with diabetic neuropathic feet. The proposed study will lead to the development of further stratification of high-risk patients into subcategories indicating the vulnerability of tissue to mechanical trauma, which deemed to be the leading cause of ulceration in people with diabetic neuropathy.

As it stands, the current systems used to evaluate the risk of diabetic foot rely on global parameters such as duration of diabetes and glycated hemoglobin to predict the likelihood and risk of diabetic foot ulceration. As ulceration happens as a result of repeat mechanical trauma to the foot that doesn't heal quickly enough due to other complications of diabetes, it is important to include mechanical measurements in predicting the ulceration incident in diabetic neuropathic patients. Despite this, the currently used risk stratification systems do not include biomechanics so by introducing biomechanics it will potentially be possible to predict the ulceration risk by using more local measurements.

The primary objective is to employ the measures of neuropathy, micro/macro-perfusion, and biomechanics of the foot mainly tissue stiffness and plantar pressure to determine the vulnerability of foot to mechanical trauma and ulceration. From the data collected it is proposed that a prognostic risk stratification system will be developed based on the range of parameters collected to identify those that are at highest risk of ulceration incident. Those that are classed as high risk are to be sub-stratified to increase the accuracy of the system in predicting ulceration. This will allow a patient-specific approach to be taken in the prevention of ulcers by providing adequate information to predict ulceration incident. This then can be used to determine the likelihood of an ulcer forming. Furthermore, the possibility of identifying the ulceration site will be investigated.

Conditions

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Diabetes Diabetic Foot Diabetes Complications Diabetes; Neuropathic (Manifestation)

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Observation group

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Observation

Intervention Type DIAGNOSTIC_TEST

The primary objective is to employ the measurements of neuropathy, micro/macro-perfusion, and biomechanics of the foot mainly tissue stiffness and plantar pressure to determine the vulnerability of foot to mechanical trauma and ulceration. From the data collected it is proposed that a prognostic risk stratification system will be developed based on the range of parameters collected to identify those that are at highest risk of ulceration incident. Those that are classed as high risk are to be sub-stratified to increase the accuracy of the system in predicting ulceration. This will allow a patient-specific approach to be taken in the prevention of ulcers by providing adequate information to predict ulceration incident.

Interventions

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Observation

The primary objective is to employ the measurements of neuropathy, micro/macro-perfusion, and biomechanics of the foot mainly tissue stiffness and plantar pressure to determine the vulnerability of foot to mechanical trauma and ulceration. From the data collected it is proposed that a prognostic risk stratification system will be developed based on the range of parameters collected to identify those that are at highest risk of ulceration incident. Those that are classed as high risk are to be sub-stratified to increase the accuracy of the system in predicting ulceration. This will allow a patient-specific approach to be taken in the prevention of ulcers by providing adequate information to predict ulceration incident.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Type 1 OR 2 diabetes
* Over 18
* English speaking
* Ability to walk unaided over 5m
* Diabetic neuropathy as defined by a 10g monofilament test

Exclusion Criteria

* Lower limb surgery (amputation)
* Active ulcers
* History of neurological disorders (apart from neuropathy)
* Orthopaedic problems
* Systemic disease affecting mobility or leading to chronic inflammation of any lower limb joint.
* Visual impairment leading to difficulties in walking
* Charcot foot
* Unable to walk unaided for 5m
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Staffordshire University

OTHER

Sponsor Role lead

Responsible Party

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Roozbeh Naemi

Associate Professor of Biomechanics

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Roozbeh Naemi, PhD

Role: PRINCIPAL_INVESTIGATOR

Staffordshire University

Nachiappan Chockalingam

Role: STUDY_CHAIR

Staffordshire University

Locations

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Staffordshire University

Stoke-on-Trent, Staffordshire, United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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1

Identifier Type: -

Identifier Source: org_study_id

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