Scotchcast Boot and Aircast Device on Foot Pressure Effects
Scotchcast Boot and Aircast Device on Foot Pressure Effects
Offloading the diabetic foot ulcer is a key element to successful wound healing. The aim of the current study was to determine whether offloading devices affect foot pressures on the contralateral foot. Foot pressures were measured in 22 diabetic patients wearing three different types of footwear on the foot with an active or recently healed ulcer, as follows: the post-op sandal (SAN) (Benefoot UK Ltd, Prestwich, United Kingdom), the Scotchcast boot (SCB), and the Aircast device (AIR) (Aircast, Inc., Lincolnshire, United Kingdom). The SAN was worn on the contralateral foot during all foot pressure measurements. The results showed that foot pressures in the contralateral foot were not different between the three different footwear conditions. There was also no difference in peak pressure time integral in the contralateral foot between the three different footwear conditions. However, an insignificant trend was noted for a longer contact time for the contralateral foot compared to the offloadeded foot for the SAN, SCB, and AIR (p=0.3, p=0.15, and p=0.05, respectively). Although there was only a small difference in contact time, this can lead to an asymmetric gait pattern and could potentially lead to overloading of the contralateral foot and/or to difficulties with maintaining balance while walking. In conclusion, although offloading devices do not seem to alter foot pressures on the contralateral foot, monitoring the contralateral foot is of paramount importance. Asymmetric gait pattern and/or difficulties with balance are essential factors to keep in mind when describing offloading devices to patients with peripheral neuropathy.
Offloading devices are commonly used to facilitate wound healing in the diabetic foot. These devices work on the principle of reducing pressure loading at the active wound site, thereby allowing the wound to heal without the constant pressure applied to the wound. Several offloading devices have been developed over the years that include commercial off-the-shelf and custom-made devices. Offloading devices are often bulky and heavy in order to allow offloading, which may potentially lead to asymmetrical gait or problems with maintaining balance during walking.
A history of foot ulceration is one of the strongest risk factors for future foot ulceration. Consequently, closely monitoring the contralateral foot when providing an offloading device to a patient is important. Although several authors have shown that offloading devices are effective in wound healing and reducing the pressure at the ulcerated foot, few have shown the effects offloading devices may have on the contralateral foot. Lavery and colleagues reported on pressures measured in the contralateral foot in patients wearing total contact casts for offloading their foot ulcers. The authors reported that reducing the peak pressure with a total contact cast on the ulcer site did not increase pressures on the contralateral foot.
The purpose of this study was to examine the effect of two different offloading devices on foot pressures on the contralateral foot. The two devices tested were the Scotchcast boot (SCB), which is a custom-made up-to-ankle-level device, and an Aircast device (AIR) (Aircast Inc., Lincolnshire, United Kingdom), an off-the-shelf, below-knee device. The authors hypothesized that there may be a different effect on the contralateral foot between an ankle- and a knee-level offloading device caused by differences in limitation of movement at the ankle joint.
The results presented in this paper are part of a larger study looking at the efficiency of the two offloading devices.
Offloading the diabetic foot ulcer is a key element to successful wound healing. The aim of the current study was to determine whether offloading devices affect foot pressures on the contralateral foot. Foot pressures were measured in 22 diabetic patients wearing three different types of footwear on the foot with an active or recently healed ulcer, as follows: the post-op sandal (SAN) (Benefoot UK Ltd, Prestwich, United Kingdom), the Scotchcast boot (SCB), and the Aircast device (AIR) (Aircast, Inc., Lincolnshire, United Kingdom). The SAN was worn on the contralateral foot during all foot pressure measurements. The results showed that foot pressures in the contralateral foot were not different between the three different footwear conditions. There was also no difference in peak pressure time integral in the contralateral foot between the three different footwear conditions. However, an insignificant trend was noted for a longer contact time for the contralateral foot compared to the offloadeded foot for the SAN, SCB, and AIR (p=0.3, p=0.15, and p=0.05, respectively). Although there was only a small difference in contact time, this can lead to an asymmetric gait pattern and could potentially lead to overloading of the contralateral foot and/or to difficulties with maintaining balance while walking. In conclusion, although offloading devices do not seem to alter foot pressures on the contralateral foot, monitoring the contralateral foot is of paramount importance. Asymmetric gait pattern and/or difficulties with balance are essential factors to keep in mind when describing offloading devices to patients with peripheral neuropathy.
Offloading devices are commonly used to facilitate wound healing in the diabetic foot. These devices work on the principle of reducing pressure loading at the active wound site, thereby allowing the wound to heal without the constant pressure applied to the wound. Several offloading devices have been developed over the years that include commercial off-the-shelf and custom-made devices. Offloading devices are often bulky and heavy in order to allow offloading, which may potentially lead to asymmetrical gait or problems with maintaining balance during walking.
A history of foot ulceration is one of the strongest risk factors for future foot ulceration. Consequently, closely monitoring the contralateral foot when providing an offloading device to a patient is important. Although several authors have shown that offloading devices are effective in wound healing and reducing the pressure at the ulcerated foot, few have shown the effects offloading devices may have on the contralateral foot. Lavery and colleagues reported on pressures measured in the contralateral foot in patients wearing total contact casts for offloading their foot ulcers. The authors reported that reducing the peak pressure with a total contact cast on the ulcer site did not increase pressures on the contralateral foot.
The purpose of this study was to examine the effect of two different offloading devices on foot pressures on the contralateral foot. The two devices tested were the Scotchcast boot (SCB), which is a custom-made up-to-ankle-level device, and an Aircast device (AIR) (Aircast Inc., Lincolnshire, United Kingdom), an off-the-shelf, below-knee device. The authors hypothesized that there may be a different effect on the contralateral foot between an ankle- and a knee-level offloading device caused by differences in limitation of movement at the ankle joint.
The results presented in this paper are part of a larger study looking at the efficiency of the two offloading devices.
