Impact of Therapeutic Footwear and Plantar Orthoses on Diabetic Neuropathic Foot in Quality of Life and Functionality

NCT ID: NCT04605900

Last Updated: 2020-10-30

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

COMPLETED

Clinical Phase

NA

Total Enrollment

43 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-13

Study Completion Date

2018-05-21

Brief Summary

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This study determines the effectiveness of plantar orthoses and custom-made orthopedic footwear in functional level and quality of life of persons with diabetes type 2 and diabetic peripheral neuropathy. This study is important due the loss of protective sensation, feet are vulnerable to minor trauma caused by plantar pressure as well as mechanical and thermal injuries. Thus, Plantar Orthoses become necessary to reduce PP and align the foot. Additionally, it is known that footwear is the most frequent cause of diabetic foot injury, since ulceration is frequently a consequence of the continuous trauma provoked by inadequate footwear. For a higher efficacy in the treatment of the foot, it is also necessary to use custom-made orthopedic footwear, indicated in the treatment of foot pathologies.

The lack of studies that evaluate the impact of this treatment on clinical measures such as quality of life and functional level, led to the development of this study, comparing a standard treatment (standard footwear and plantar orthoses) with an optimal treatment suggested in diabetic foot guidelines (therapeutic footwear and plantar orthoses).

Detailed Description

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This clinical trial includes 2 parallel intervention groups with a pre- and post-test analysis. In the standard footwear (SF) group, plantar orthoses, standard footwear and education on foot self-care were applied and in the orthopedic footwear (OF) group the same intervention was applied, but with orthopedic footwear.

Both intervention groups were evaluated at two different time points, with the pre-test taking place at the beginning of the study (T0 - Baseline) and the post-test taking place 4 months after the application of the treatment (T4). In the middle of the study, at two months (T2) a questionnaire was applied in order to understand the adherence and the perception of individuals about the intervention applied.

The screening of diabetic peripheral neuropathy was made with the Michigan Neuropathy Screening Instrument (MNSI) and the description of the sample with an evaluation questionnaire.

The FL was evaluated through the Lower Extremity Functional Scale (LEFS), physical tests and the postural, static and dynamic barometric assessment. QoL was assessed with SF-36 and the adherence and satisfaction with a questionnaire created ad hoc.

Conditions

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Diabetes Mellitus, Type 2 Diabetic Peripheral Neuropathy

Keywords

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Quality of life Postural Balance Functionality Foot Orthoses Footwear

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A pre and post-test analysis was performed.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Standard Footwear (SF)

Intervention: plantar orthoses, education on foot self-care and appropriate standard footwear.

Group Type EXPERIMENTAL

Standard Footwear

Intervention Type DEVICE

In the SF Group, it was recommended to use standard shoes more suitable for diabetic foot, with some specific characteristics, such as sports or walking shoes. The acquisition or not of a more suitable shoes by the participants was at the discretion of each individual.

Plantar Orthoses

Intervention Type DEVICE

The plantar orthoses (PO) that both groups used for distribute of plantar loads was based on the principle of total contact. The confection material consisted in a liner of EVA shore 20º and polyurethane filling ELAX flexible (expandable) from OKM Química Ortopédica SL.

Education on foot self-care

Intervention Type BEHAVIORAL

An information leaflet with foot care was delivered, with the aim of ensuring that participants were informed about the care they should continually take with their feet during the study period. This leaflet was created based on the guidelines of the "Associação Protetora dos Diabéticos" in Portugal.

Orthopedic Footwear (OF)

Intervention: plantar orthoses, education on foot self-care and orthopedic footwear.

Group Type EXPERIMENTAL

Orthopedic Footwear

Intervention Type DEVICE

The orthopedic footwear used by the OF Group was manufactured by the company J. Andrade Ferreira Neves Lda. with materials suitable for the diabetic foot, as registered with INFARMED under registration ID 279515.

Plantar Orthoses

Intervention Type DEVICE

The plantar orthoses (PO) that both groups used for distribute of plantar loads was based on the principle of total contact. The confection material consisted in a liner of EVA shore 20º and polyurethane filling ELAX flexible (expandable) from OKM Química Ortopédica SL.

Education on foot self-care

Intervention Type BEHAVIORAL

An information leaflet with foot care was delivered, with the aim of ensuring that participants were informed about the care they should continually take with their feet during the study period. This leaflet was created based on the guidelines of the "Associação Protetora dos Diabéticos" in Portugal.

Interventions

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Orthopedic Footwear

The orthopedic footwear used by the OF Group was manufactured by the company J. Andrade Ferreira Neves Lda. with materials suitable for the diabetic foot, as registered with INFARMED under registration ID 279515.

Intervention Type DEVICE

Standard Footwear

In the SF Group, it was recommended to use standard shoes more suitable for diabetic foot, with some specific characteristics, such as sports or walking shoes. The acquisition or not of a more suitable shoes by the participants was at the discretion of each individual.

Intervention Type DEVICE

Plantar Orthoses

The plantar orthoses (PO) that both groups used for distribute of plantar loads was based on the principle of total contact. The confection material consisted in a liner of EVA shore 20º and polyurethane filling ELAX flexible (expandable) from OKM Química Ortopédica SL.

Intervention Type DEVICE

Education on foot self-care

An information leaflet with foot care was delivered, with the aim of ensuring that participants were informed about the care they should continually take with their feet during the study period. This leaflet was created based on the guidelines of the "Associação Protetora dos Diabéticos" in Portugal.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Presence of type 2 DM;
* Have at least 6 months from diagnosis of DM;
* Presence of Diabetic Polyneuropathy;
* No history of plantar orthoses and orthopedic footwear use.

Exclusion Criteria

* Active ulceration;
* Severe osteoarticular deformities;
* Presence of cognitive impairment;
* Gait with technical devices;
* Diagnosis of neurological pathology that can affect the gait pattern;
* Diagnosis of another pathology that can negatively influence the study: depression, the presence of uncontrolled cardiovascular diseases and active cancer.
* Surgical interventions on the spine and lower limbs, with less than 1 year of recovery.
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Huelva

OTHER

Sponsor Role collaborator

OKM Química Ortopédica S.L.

UNKNOWN

Sponsor Role collaborator

Lola - J. Andrade Ferreira Neves Lda

UNKNOWN

Sponsor Role collaborator

Instituto São João de Deus (ISJD)

UNKNOWN

Sponsor Role collaborator

Ortobalance - Ortopedia Técnica e Desportiva

UNKNOWN

Sponsor Role collaborator

Sensor Médica

UNKNOWN

Sponsor Role collaborator

Pierre Fabre Portugal

UNKNOWN

Sponsor Role collaborator

Associação para o Estudo da Diabetes Mellitus e de Apoio ao Diabético do Algarve (AEDMADA)

UNKNOWN

Sponsor Role collaborator

Unidade Funcional de Faro - Agrupamento de Centros de Saúde do Central

UNKNOWN

Sponsor Role collaborator

Universidade do Algarve

OTHER

Sponsor Role lead

Responsible Party

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Marta Botelho

Research Fellowship

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marta Botelho, PhD

Role: PRINCIPAL_INVESTIGATOR

Researcher

Locations

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Marta Botelho

Faro, Algarve, Portugal

Site Status

Countries

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Portugal

Other Identifiers

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0348_CIE_6_E

Identifier Type: -

Identifier Source: org_study_id