2005 Symposium on Advanced Wound Care | |
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Clinical Research
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Use of traditional off-weighting devices for pressure reduction at the heel. James W. Bellew, EdD, PT, Edward Mahoney, MSPT, Kristin Shelley, SPT, Rachael Click, SPT, Joseph M. McCulloch, PhD, PT, CWS, FAPTA, Marshall Cunningham, MD, Louisiana State University Health Sciences Center, Shreveport, LA Purpose. Off-weighting is a common means of managing forefoot ulcerations. While many off-weighting devices are available, little data are available supporting their use in reducing plantar pressure at the heel. Therefore, the intent of this study was to examine the reduction in heel pressure when using various off-weighting techniques. Methods. Five men and 5 women (25-34 years) were examined. Peak plantar pressure of the heel was recorded using the F-Scan™ portable, in shoe, pedo-barographic measurement system by Tekscan. Pressure sensing insoles were used to quantify baseline heel pressure during barefoot walking and during walking with, in randomized order, a DH2, diabetic shoe, heel wedge, and total contact casting (TCC). One-way ANOVA with post-hoc testing was used to assess differences between devices. Results: Peak plantar heel pressures were significantly less than barefoot walking (P<.001) and total contact casting (P<.004) when using the DH2, heel wedge, or diabetic shoe. There was no difference, however, in pressure reduction between the DH2, heel wedge, and diabetic shoe, nor was there a difference between barefoot walking and TCC conditions. Conclusions: When compared to barefoot walking or total contact casting, plantar heel pressure was significantly reduced when using a DH2, heel wedge, or diabetic shoe. |
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