Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Dec 9:8:71.
doi: 10.1186/s13047-015-0130-5. eCollection 2015.

Vascular assessment techniques of podiatrists in Australia and New Zealand: a web-based survey

Peta Ellen Tehan  1 , Vivienne Helaine Chuter  1
Affiliations

Vascular assessment techniques of podiatrists in Australia and New Zealand: a web-based survey

Peta Ellen Tehan et al. J Foot Ankle Res. .

Abstract

Background: Podiatrists play a central role in conducting non-invasive vascular assessment in the lower extremity. This involves screening for signs and symptoms of peripheral arterial disease (PAD) and ongoing monitoring of the condition. Podiatric vascular assessment practices in Australia and New Zealand are currently unclear. Determining the clinical habits of Podiatrists is essential in identifying if there is a need for further education or support in performing accurate vascular assessments.

Methods: A web-based, secure, anonymous questionnaire was conducted of registered Podiatrists in Australia and New Zealand between 1 April and 31 July 2013. The questions examined clinician's regular practices in vascular assessment, clinical indicators to perform and barriers in completing vascular assessment. Nominal logistic regression was performed to further examine years of experience and practice setting on clinical indicators to perform vascular assessment and types of assessment performed.

Results: Four hundred forty-seven podiatrists participated in the survey. Clinical indicators for vascular assessment, along with barriers and available equipment were examined and the results varied depending on the podiatrists' geographical location, practice setting, and experience. Palpation of pedal pulses was the most frequently reported assessment (97 %) along with Doppler assessment (74 %). Pressure measurement was the least frequently reported vascular assessment method, with only 34 % undertaking ankle-brachial indices and 19 % completing toe-brachial indices. Public podiatrists reported more varied and complete vascular assessment compared to those in private practice. Lack of time was identified as the most frequently reported barrier (66 %) in performing vascular assessment, followed by lack of equipment (28 %). In New Zealand podiatrists, lack of equipment was much more of an issue than in Australian podiatrists.

Conclusion: Large variations exist in vascular assessment methods amongst Australian and New Zealand podiatrists. Some assessments being undertaken are potentially inadequate for accurate screening for PAD. There is a need for continuing education in vascular assessment to address the deficiencies in technique reported by some Podiatrists. A podiatry-relevant summary of broad international guidelines for PAD screening may be of use to improve utilisation and accuracy of screening methods to improve patient management.

Keywords: Clinical practice; Non-invasive vascular assessment; Podiatrist; Survey.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Clinical indicators for podiatrists to perform vascular assessment
Fig. 2
Fig. 2
Diagnostic testing methods employed by podiatrists
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA guidelines for the management of patients with peripheral arterial disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) J Vasc Interv Radiol. 2006;17(9):1383–98. doi: 10.1097/01.RVI.0000240426.53079.46. - DOI - PubMed
    1. Andras A, Ferket B. Screening for peripheral arterial disease. Cochrane Database Syst Rev. 2014;4:CD010835. - PMC - PubMed
    1. Smieja M, Hunt D, Edelman D, Etchells E, Comuz J, Simel D. International Cooperative Group for Clinical Examination Research. Clinical examination for the detection of protective sensation in the feet of diabetic patients. J Gen Intern Med. 1999;14(7):418–24. doi: 10.1046/j.1525-1497.1999.05208.x. - DOI - PMC - PubMed
    1. Caruana MF, Bradbury AW, Adam DJ. The validity, reliability, reproducibility and extended utility of ankle to brachial pressure index in current vascular surgical practice. Eur J Vasc Endovasc Surg. 2005;29(5):443–51. doi: 10.1016/j.ejvs.2005.01.015. - DOI - PubMed
    1. Cloete N, Kiely C, Colgan P, Haider N, O’Neill S, Madhavan P, et al. Reproducibility of toe pressure measurements. JVU. 2009;33(3):129–32.