Activity Worth: 1 CPD hours

Australasian Podiatry Conference 2017: Association between ankle equinus and plantar pressures in people with diabetes. A systematic review and meta-analysis - APodC

by Angela Searle, Martin Spink, Alan Ho, Vivienne Chuter on Thursday, 25 April 2120 - 3:07pm

Australasian Podiatry Conference 2017: selected abstracts

The Australasian Podiatry Conference 2017 featured an array of great speakers and exemplary papers.

We are pleased to provide here one of the conference abstracts and invite you to read the abstract and then complete the writing task detailed below.

CPD Activity: Value – 1 hour – Consider category 4 Self-directed Learning under Podiatry Board of Australia Guidelines.  Consider also Category 3 Quality Improvement Activities under the guidelines

23 Association between ankle equinus and plantar pressures in people with diabetes. A systematic review and meta-analysis

Angela Searle, Martin Spink, Alan Ho, Vivienne Chuter

University of Newcastle, NSW, Australia

Correspondence: Martin Spink

 

Objectives

Diabetes related restriction in ankle joint range of dorsiflexion is proposed to contribute to elevated plantar pressures implicated in the development of foot ulcers. The aim of this review was to investigate the evidence of an association between limited ankle joint dorsiflexion and plantar pressures in people with diabetes.

Method

A systematic search of EBSCO Megafile Premier (containing MEDLINE, CINAHL, SPORTSdiscus, Academic Search Complete) and The Cochrane Library was conducted to 23rd November 2016. Two authors independently reviewed and selected relevant studies. Included studies investigated ankle dorsiflexion range of motion and plantar pressures in people with diabetes. Studies were excluded where the individuals had current plantar foot ulcers, neurologically induced limited ankle joint range of motion (e.g. stroke or cerebral palsy), or the studies reported ground reaction forces or joint moments only, or the data could not be obtained.

Results

Fifteen studies met the inclusion criteria. Three studies in the meta-analysis found that equinus increases plantar pressures with a small, but significant effect size (ES = 0.26, CI 95% 0.11 to 0.41, p = 0.001). Of the remaining twelve studies, eight found evidence of an association between limited ankle dorsiflexion and increased plantar pressures while four studies found no relationship. Limited ankle dorsiflexion and increased plantar pressures were found in all studies where the sample population had a history of neuropathic foot ulceration. The same association was not found in studies where the population had neuropathy and no history of foot ulcer.

Conclusions

Limited ankle joint dorsiflexion may contribute to elevating plantar pressures in people with diabetes. An equinus may be an early clinical indicator of increased ulcer risk, and it would be advisable for clinicians to assess for this movement restriction, especially in high risk groups such as those with neuropathy.

The task

Read the abstract, then prepare a brief paper (250 – 500 words) in which you explain why the subject matter is important to you. Give your initial response, and then write about the aspect you have chosen to reflect upon. You may wish to relate to your own skills, professional experience or discipline knowledge.

Outline any changes in your understanding and/or behaviour as a result of the experience. What actions may flow from your engagement? Explain the implications for this in your future professional practice. What actions might you take and why?

Don’t forget to upload your completed work to your e-portfolio, citing paper number and title, as evidence of completion.

This abstract can be viewed at the below link.  This abstract is number 23.

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