Wear-and-tear of therapeutic footwear,

NewsBot · May 18, 2018

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Evaluation of the wear-and-tear scale for therapeutic footwear, results of a generalizability study.
Dahmen R, Siemonsma PC, Monteiro S, Norman GR, Boers M, Lankhorst GJ, Roorda LD.
J Rehabil Med. 2018 May 16

OBJECTIVE:
Therapeutic footwear is often prescribed at considerable cost. Foot-care specialists normally assess the wear-and-tear of therapeutic footwear in order to monitor the adequacy of the prescribed footwear and to gain an indicator of its use. We developed a simple, rapid, easily applicable indicator of wear-and-tear of therapeutic footwear: the wear-and-tear scale. The aim of this study was to investigate the intra- and inter-rater reliability of the wear-and-tear scale.

METHODS:
A test set of 100 therapeutic shoes was assembled; 24 raters (6 inexperienced and 6 experienced physiatrists, and 6 inexperienced and 6 experienced orthopaedic shoe technicians) rated the degree of wear-and-tear of the shoes on the scale (range 0-100) twice on 1 day with a 4-h interval (short-term) and twice over a 4-week interval (long-term). Generalizability theory was applied for the analysis.

RESULTS:
Short-term, long-term and overall intra-rater reliability was excellent (coefficients 0.99, 0.99 and 0.98; standard error of measurement (SEM) 2.6, 2.9 and 3.9; smallest detectable changes (SDC) 7.3, 8.0 and 10.8, respectively). Inter-rater reliability between professions, experience and inexperienced raters, and overall was excellent (coefficients 0.97, 0.98 and 0.93; SEM 4.9, 4.5, and 8.1; SDC 13.7, 12.4 and 22.5, respectively).

CONCLUSION:
The wear-and-tear scale has excellent intra-rater, inter-rater, and overall reliability.
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NewsBot · Jun 28, 2022

Effects of wear and tear of therapeutic footwear in patients remission. A 5-year follow-up study
Mateo López-Moral et al
Diabetes Res Clin Pract. 2022 Jun 24

Aims: to assesses the relationship between the wear and tear of therapeutic footwear (TF) and the risk of recurrence in diabetes remission patients.

Methods: Remission patients (N=115) participated in this 5-year prospective study in a specialized Diabetic Foot Unit between October 2016 and January 2022. Patients' TF was assessed in a three-month interval from Day 0 until ulcer recurrence was found. Primary outcome measure was based on the recurrent event in the forefoot.

Results: A total of 82 patients (71.3%) renewed their TF, and 33 patients (28.7%) did not renew their TF during the follow-up period. Patients who failed to renew their TF group experienced more recurrent events (22 vs 14, p <.001, CI [0.04-0.259]) and minor amputations (11 vs 8, p = .002, CI [0.07-0.6]). Both groups showed different recurrence-free survival median times of 205.5 [Interquartile range (IQR) - 188-222] weeks and 89.9 [IQR - 53-126] weeks. Patients who did not renew their TF increased their risk of suffering from a recurrent event in the Cox regression model (p < .001, CI [0.03-0.38], Hazzard Ratio 0.147).

Conclusions: Patients who renewed their TF because of wear and tear experienced lower recurrences and minor amputations.
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