Is walking barefoot a risk factor for diabetic foot disease in developing countries?
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Walking barefoot is common in poorer developing countries which have large rural populations. Although high rates of foot injury could be expected among those who walk barefoot, walking barefoot as a risk factor for diabetic foot disease is rarely documented in the literature.Two preliminary clinical studies were undertaken to investigate whether there is a causal link between walking barefoot and diabetic foot ulcers. The first study investigated whether being barefoot was a factor in initiating foot ulceration. In the second study, 204 consecutive diabetic outpatients were studied to further investigate the association between diabetic foot disease and walking barefoot.In the first study, of the 75 consecutive diabetics admitted for foot ulceration of less than 4 weeks, 32 (42.4%) had foot ulcers resulting from injuries by sharp or hard objects. Of those injured, 27 (84%) were barefoot at the time of the injury. This suggested that walking barefoot is a risk factor for foot ulcers, and that using footwear has the potential to prevent foot ulcers. In the second study, the relative risk of foot ulcers among barefoot diabetics was 2.21 (95% CI 1.55 to 3.14) compared with those using some form of footwear. A history of foot ulcers was more frequent in the group who wore footwear less than 10 hours per day, compared with those who used footwear more than 10 hours. The prevalence of web space and nail infections was also higher in the group who wore footwear less than 10 hours per day, compared with those who used footwear for more than 10 hours.The data suggest that walking barefoot is a risk factor for diabetic foot disease. Thus, public health messages in developing countries with large rural populations who walk barefoot should strongly advise diabetics to use footwear for a greater part of the day. This may be overlook in literature originating from affluent countries where footwear use is the norm. Further studies are indicated to investigate potential associations between walking barefoot, rurality and cultural factors.Keywords:
Barefoot
Foot (prosody)
Objective:To guard tertiary prevention of diabetic foot ulcer,we investigated danger condition of diabetic foot.Methods:General clinical data,results of laboratory examination,and foot ulcer correlated contents including foot condition were screened using diabetic foot diagnose box(Huntieigh;England)in 148 cases of diabetics.Gavin′s risk factors of diabetic foot were assessed with weighted value integration.Results:28 hyp-danger foot(18.92%),69 moderate danger foot(46.62%),43 high danger foot(29.05%) and 8 normal foot(5.40%) were identified.Conclusion:The risk of foot ulcer in diabetics is high.To prevent diabetic foot development and decrease mutilation and fatality,we should strengthen diabetic foot screening and tertiary prevention of diabetic foot according to foot ulcer danger classes.
Foot (prosody)
Diabetic foot ulcer
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Background: Barefoot running is slowly gaining a dedicated following. Proponents of barefoot running claim many benefits, such as improved performance and reduced injuries, whereas detractors warn of the imminent risks involved. Methods: Multiple publications were reviewed using key words. Results: A review of the literature uncovered many studies that have looked at the barefoot condition and found notable differences in gait and other parameters. These findings, along with much anecdotal information, can lead one to extrapolate that barefoot runners should have fewer injuries, better performance, or both. Several athletic shoe companies have designed running shoes that attempt to mimic the barefoot condition and, thus, garner the purported benefits of barefoot running. Conclusions: Although there is no evidence that either confirms or refutes improved performance and reduced injuries in barefoot runners, many of the claimed disadvantages to barefoot running are not supported by the literature. Nonetheless, it seems that barefoot running may be an acceptable training method for athletes and coaches who understand and can minimize the risks. (J Am Podiatr Med Assoc 101(3): 231–246, 2011)
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Walking barefoot is common in poorer developing countries which have large rural populations. Although high rates of foot injury could be expected among those who walk barefoot, walking barefoot as a risk factor for diabetic foot disease is rarely documented in the literature.Two preliminary clinical studies were undertaken to investigate whether there is a causal link between walking barefoot and diabetic foot ulcers. The first study investigated whether being barefoot was a factor in initiating foot ulceration. In the second study, 204 consecutive diabetic outpatients were studied to further investigate the association between diabetic foot disease and walking barefoot.In the first study, of the 75 consecutive diabetics admitted for foot ulceration of less than 4 weeks, 32 (42.4%) had foot ulcers resulting from injuries by sharp or hard objects. Of those injured, 27 (84%) were barefoot at the time of the injury. This suggested that walking barefoot is a risk factor for foot ulcers, and that using footwear has the potential to prevent foot ulcers. In the second study, the relative risk of foot ulcers among barefoot diabetics was 2.21 (95% CI 1.55 to 3.14) compared with those using some form of footwear. A history of foot ulcers was more frequent in the group who wore footwear less than 10 hours per day, compared with those who used footwear more than 10 hours. The prevalence of web space and nail infections was also higher in the group who wore footwear less than 10 hours per day, compared with those who used footwear for more than 10 hours.The data suggest that walking barefoot is a risk factor for diabetic foot disease. Thus, public health messages in developing countries with large rural populations who walk barefoot should strongly advise diabetics to use footwear for a greater part of the day. This may be overlook in literature originating from affluent countries where footwear use is the norm. Further studies are indicated to investigate potential associations between walking barefoot, rurality and cultural factors.
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Foot (prosody)
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Objective Clinical evaluation of the situation about the foot of diabetic patients.Methods The foot situation of 195 cases of diabetic patients were assessed and also,the patients were given a test about foot care knowledge.Results The skin of the foot in diabetic patients was in poor condition,the fungal infection of foot was the most common,accounting for 78.97%,followed by the incidence of the corpus callosity and clavus,accounting for 54.36%,dry or chapped skin accounted for 16.92%.Diabetic patients were on a serious lack of diabetic foot knowledge.Conclusion It is most important to enhance education about foot care knowledge and regularly foot screen.which is the crucial to prevent diabetic foot lesions.
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Foot care
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Background Variations in foot posture are associated with common lower limb injuries. However, there is uncertainty as to which measure of foot posture is the most valid in terms of predicting 3-dimensional kinematics of the foot. The aim of this study was to investigate the association between measures of static foot posture or foot mobility and kinematic variables of the foot during barefoot walking.
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Foot (prosody)
Foot Orthoses
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Design: This is a cross-sectional study.Background: There was not a study in the past which exclusively defines and reports foot defects, deformities, and diseases among barefoot and shod endurance runners.Methods: Participants were added by snowball sampling method after fulfilling inclusion criteria as barefoot runners (n = 80), shod runners (n = 80), and healthy collegiate nonrunners (controls n = 80) from Dakshina Karnataka, India. Outcome Measures: Foot deformities, foot defects, and diseases were identified using valid tools.Results: All foot defects, deformities, and diseases for three groups were identified and analyzed by one-way ANOVA which revealed a significant difference in the foot defects, deformities, and diseases (P < 0.01). Type of running, duration of running, and foot type were associated with the foot defects, deformities, and diseases in each group at 95% confidence interval. Conclusion: This study concluded that there exists a significant difference in foot defects, deformities, and diseases between three groups and found a strong association between specific type of running, duration of running, and foot type with the foot defects, deformities, and diseases. Hence, this study alarms runners, coaches, and shoe manufacturers to work on strategies to prevent all foot problems reported among runners.
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Foot wounds are complications of type II diabetes mellitus (T2DM), which may be prevented with proper foot assessments. Diabetic foot exams are not consistently performed despite evidence-based screening tools available. Objective: To determine if the implementation of an electronic medical record (EMR) alert using Inlow’s 60-Second Diabetic Foot Screen would impact the number of diabetic foot exams performed among T2DM patients at a primary care level. Method: A quantitative quasi-experiment design was used to implement an electronic medical record (EMR) alert using Inlow’s 60-Second Diabetic Foot Screen to impact the frequencies of diabetic foot exams. Sample size was 65, n=35 in the comparative group and n= 30 in the implementation group. Population consisted of male and female patients ages 18 years and older, diagnosed with T2DM within the last two years, no previous diabetic foot exams or received foot care education, did not perform self-reported foot inspections, and were able to read, write, and speak English. A chi square test was run to analyze the frequencies of foot exams between groups. Results: A Pearson’s chi-square showed a statistically significant increase in the foot exams X2 (1, N=65) = 5.286, p= 0.02 using an EMR alert with Inlow’s 60-Second Diabetic Foot screen. Conclusion: EMR alerts increase performance of diabetic foot exams. Recommendations include sustainment of the program, dissemination of results, and further investigation of the impact of EMR alerts. Keywords: Diabetes, Foot screening, EMR alert
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Foot care
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Medical record
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Objective To investigate the clinical characteristics of diabetic foot in our hospital.Methods Diabetic patients with foot problems and/or peripher alartery diseases were surveyed from September,1999 to December,2007 in our hospital,including demographic data,present and past history of the foot and peripher alartery diseases,the classification and phases of the foot ulcers based on the Wagner system,control of the hyperglycemia and lipid disorder,medical cost in hospital and the diabetic comp lications and relativerisk factors.Results In the study,61 diabetic patients with foot problems were analyzed.In diabetic foot group,male had more diabetic food than female,foot problems most frequently occurred in the elderly diabetic patients with long duration,lower educational level.Ulcers were complicated with infection.The average direct medical cost in hospital for the diabetic patients with foot problems was RMB 7085 yuan.Conclusions Foot problems markedly increase the medical cost of the diabetic patients.The elderly diabetic men' s patients with long duration,lower educational level,restrict control of diet and should be paid more attention on intensifying foot care and preventing education of foot problems.
Key words:
Diabetic foot; Health education
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Throughout history, members of human societies have gone barefoot, and those societies seemingly had a low incidence of foot deformities and pain. Only one study has addressed the problem of infection through injury to the bare foot; otherwise, the unshod foot seems to have had minimal problems. Initially shoes were made in the shape of the foot and were sandals. Over time, shoes became decorative items and symbols of status and vanity. As the shape of shoes changed, they became deforming forces on the foot and the source of pain. Recent studies by the Council on Women's Footwear of the American Orthopaedic Foot and Ankle Society have tried to document the problems caused by shoes on the feet of American women. Attempts should continue to educate women on appropriate shoes and proper fit.
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