Evaluation of balance, gait disturbance, and energy consumption in diabetic foot ulcer patients using removable knee high, ankle high, and therapeutic footwear offloading devices

Abstract

Removable knee high or ankle high offloading device used to assist diabetic foot ulcer healing and therapeutic footwear helps to reduce recurrent ulcers in persons with diabetes. The measurement of energy consumption is particularlyessential in the research of the link between physical activity and health since it canhelp promote a healthy lifestyle and prolong life. The purpose of this study was to evaluate the outcomes of gait, balance and energy consumption of diabetes foot ulcer patients walking in three different offloading devices

knee-high, ankle-high and therapeutic footwear by 10-meter walk test (10MWT) and energy expenditure test (6-minutes’ walk in treadmill) with 0° and 5° inclination at self-selected comfortable speed.10-meter walk test of knee-high, ankle-high and therapeutic footwear were

walking speed (0.98, 0.67, 1.13) m/s, step length (50.85, 52.01, 43.65)%, stride length(1.26, 0.94, 1.12)m and Symmetry index (95.3, 95.4, 88.67)% respectively and the energy consumption illustrated for 0° inclination

7ml/kg/min, 11ml/kg/min, 8ml/kg/min, and 5° inclination

11 ml/kg/min, 12 ml/kg/min, 9 ml/kg/min, respectively. Knee-high offloading offered a similar result to G-walk normative data whilst ankle-high secondly and therapeutic footwear lastly. There were no issues in energyexpenditure in all three conditions. Future work is on-going to recruit more participants and to explore the possible relationship between walking parameters and the energy expenditure outcomes per device type in DFU patients. As this is a preliminary study, this study is fundamental for future studies in diabetic ulcers patient walking with different offloading devices. IMPLICATION OF THESIS. This study will benefit diabetic foot ulcer patients walking with offloading devices provides information to improve balance, gait, compared to walking with bare feet. This study can share with clinicians a way to think about the proper prescription of offloading devices in terms of balance and energy consumption for diabetic foot ulcer patient