The effect of computerized custom insole with custom-fit insole on the function of the foot and ankle and quality of life in diabetic elderly

Background: Diabetes alters the distribution of foot pressure and causes foot ulceration and changes the quality of life and function of the foot and ankle. Insole is one of the treatment options to improve the distribution of foot pressure and prevent foot ulcers. The purpose of the present study is to compare the effect of the computerized custom insole with a custom-fit insole on the function of the foot and ankle and quality of life of diabetic elderly. Methods: 28 Diabetic patients (14 males and 14 females, typeⅠand Ⅱ) were included in the study with the approval of a specialist physician if they met the inclusion criteria. The mean and standard deviation of participantschr('39') demographic variables for age, weight, height, and BMI for test and control groups were 67.64±5.23 years, 66.79± 4.68 years, 76.44±11.48 kg, 77.24±11.95 kg, and 1.67±8 m, 1.67±5 m, 27.55±5.08 kg/m2, 26.52±5.33 kg/m2 respectively. Participants were randomly allocated to the computerized custom insole (test group) and custom-fit insole (control group). Both groups used the insoles for 4-6 weeks. Participants were asked to complete the Persian version of the brief DQOL questionnaire once before using the insoles and once 4-6 weeks after using the insoles. Also, a full version of AOFAS questionnaire was completed by researcher for each patient once before using the insoles and once 4 - 6 weeks after using the insoles. Results: In the pre-intervention phase, there was no significant difference in the quality of life and function of the foot and ankle of the elderlies in the two groups and the quantitative data in both groups had a normal distribution. After 4 to 6 weeks, there was a significant difference in the quality of life and function of the foot and ankle of the elderlies in the two groups in both groups (p0.05). Conclusion: The results showed that there was no significant difference in the effectiveness of these two types of insole on the quality of life and function of foot and ankle; it is recommended to use a custom-fit insole that will cost the patient less

The Effect of Rocker Shoe on the Ground Reaction Force Parameters in Patients with Rheumatoid Arthritis

Objectives: Foot and ankle problems are common complications in rheumatoid arthritis disease. Gait pattern such as normal foot and ankle rocker is impaired in patients with rheumatoid arthritis. Rocker sole as an external shoe modification is commonly prescribed in this pathology. The aim of this study was to investigate the effect of rocker shoe on vertical ground reaction force parameters during walking in patients with rheumatoid arthritis. Methods: Sixteen female participants with rheumatoid arthritis were recruited in this study. All patients were prepared with a pair of high-top, heel-to-toe rocker shoe and were asked to wear the shoes for one month. Ground reaction force parameters including peak forces and peak force times were evaluated in the first session, and after seven days and thirty days follow up were carried on. Results: first maximal vertical force was significantly increased with rocker shoe compared to barefoot after 7 days follow up. Walking with rocker shoe reduced the minimal vertical force after 7 days. The second maximal vertical force showed to be statistically lower with rocker shoes than barefoot after 7 and 30 days. Furthermore, stance time decreased with rocker shoe after one month. Discussion: Results of this study revealed that vertical ground reaction force parameters changed in rheumatoid arthritis patients with heel-to-toe rocker shoe, both immediately and after one month follow up. This might suggest the effectiveness of rocker shoes in improving gait in rheumatoid arthritis patients

The Validity and Reliability of Kinovea Software in Measuring Thoracic Kyphosis and Lumbar Lordosis

Objectives: The present study evaluated the inter-rater and intra-rater validity and reliability of posturography by Kinovea software to measure the thoracic kyphosis and lumbar lordosis. Methods: Eighteen subjects (10 females & 8 males) referring for radiographic imaging were included in this cross-sectional study. For evaluating the validity, the thoracic kyphosis and lumbar lordosis were measured according to the Cobb method and Kinovea in standing position. The inter-rater and intra-rater reliability of Kinovea were tested by 3 evaluators and one expert evaluator, respectively. Results: Pearson correlation coefficient data suggested that the validity of measuring the thoracic kyphosis depends on the evaluator’s expertise. Besides, the correlation was not significant in measuring the lumbar lordosis angle (P>0.05). The inter-rater and intra-rater repeatability revealed that the correlation was significant in all angles by the intraclass correlation coefficient (P<0.001). Discussion: Posturography by Kinovea, as a noninvasive method presents an excellent inter-rater and intra-rater repeatability for measuring thoracic kyphosis and lumbar lordosis. This reliable method is simple, efficient, and inexpensive