Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Undergraduate Research...Callus debridement in rheumatoid arthritis

Discussion in 'General Issues and Discussion Forum' started by rachel.liminton, Nov 24, 2009.

  1. rachel.liminton

    rachel.liminton Active Member


    Members do not see these Ads. Sign Up.
    Hi folks,

    I'm a 3rd year undergraduate podiatry student who is in the process of looking into the effectiveness of callus debridement for pain relief, quality of life and ulcer prevention in people with rheumatoid arthritis. I would be most grateful for other podiatrists and researchers thoughts on this matter.


    Kind Regards

    Rachel Liminton:craig::craig::confused::confused:
     
  2. Footsies

    Footsies Active Member

    I know there is a research article that looks at callus debridement vs insole therapy for painful plantar callosities..... not sure if that would help as it is not specific to RA - but could be a useful starting point for your research design etc....
     
  3. A study we published is here: http://www.apodc.com.au/AJPM/Contents/volume_392.htm

    You should also see:
    Redmond A, et al. (1999) Effect of scalpel debridement on the pain of plantar hyperkeratosis. JAPMA 89: 10 515-519

    and
    Woodburn J, Stableford Z, Helliwell PS (2000) Preliminary investigation of debridement of plantar callosities in rheumatoid arthritis. Rheumatology 39: 6 652-654
     
  4. Johnpod

    Johnpod Active Member

    This paper may also prove useful:

    BALANOWSKI, K.R., FLYNN, L.M., 2005 Effect of painful keratoses debridement on foot pain, balance and function in older adults. Gait and Posture. Dec; 22(4): 302-7.
     
  5. rachel.liminton

    rachel.liminton Active Member

    Thanks guys,

    This information has been really helpful. I know a lot of research has been done to understand the role of callus debridement, especially with regards to diabetes and ulcer prevention. However in RA it seems to be a different ball game....I will certainly follow up these pointers. Thank you once again.
    Kind regards
    Rachel:drinks:drinks
     
  6. Footsies

    Footsies Active Member

    Please feel free to pass on your results when you get them! ;)
     
  7. wdd

    wdd Well-Known Member

    Dear Rachel,

    I am sure that when you do your literature search you are going to come across articles, like one that Simon suggests, by Woodburn J, Stableford Z & Helliwell PS, which compare plantar pressures before and after callus reduction.

    A part of my concern with this type of research is that pressure measurements taken before and after callus reduction are measuring and then comparing measurements taken at a different interfaces, ie ‘before’ measurements are taken at the sensor /callus interface and ‘after’ measurements are taken at the sensor/reduced callus interface but following discussion seems to assumes that the measurements are taken at the same interface and can reasonably be compared.

    It seems to me that it is like measuring the plantar pressures between the sole of the shoe and the ground and assuming that these measurements will be the same as those between the insole and the plantar aspect of the foot.

    Of course the sole of the shoe is unlikely to have the same mechanical characteristics as callus but interposition of callus is likely to modify the forces being transmitted to the underlying living tissues. The effects of callus on the transmission of forces needs to be considered and it cannot simply be assumed that callus has no effect on force transmission.

    If callus does not modify the forces (not just the force at right angles to the sensor) transmitted through it then there is no problem with this type of research but if the callus does modify the transmitted forces then conclusions based on such research are flawed in direct proportion to the force modifying effects of callus.

    Best wishes,

    Bill Donaldson
     
  8. distalphalanx

    distalphalanx Member

    Hi Rachel, i think the general thinking with callus debridement in the RA foot is little and often. Callus is thought to act as a tethering on the foot and over debriding can lead to the RA foot becoming more "at risk" . Several studies have been carried out on this, most have been listed already, i have included a link to a RCT . The evidence suggests that pain reduction was reported but was only short lived (7 days) in one trial and function and pressure there was no significant difference. However, heavy callus increases pressure and therefore would increase the risk of ulceration in the Rheumatoid foot.

    http://rheumatology.oxfordjournals.org/cgi/content/full/44/2/207
     
  9. Footsies

    Footsies Active Member

    You are also going to have issues with debridement - who debrides - the same person for each subject? There are variabilities between practitioners and their technique and how much callus they debride!
     
Loading...

Share This Page