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
. 2023 May 11;16(1):27.
doi: 10.1186/s13047-023-00625-z.

Offloading effects of a removable cast walker with and without modification for diabetes-related foot ulceration: a plantar pressure study

Rebekah V Withers  1 , Byron M Perrin  2 , Karl B Landorf  1 , Anita Raspovic  3
Affiliations

Offloading effects of a removable cast walker with and without modification for diabetes-related foot ulceration: a plantar pressure study

Rebekah V Withers et al. J Foot Ankle Res. .

Abstract

Background: Removable cast walkers (RCWs), with or without modifications, are used to offload diabetes-related foot ulcers (DRFUs), however there is limited data relating to their offloading effects. This study aimed to quantify plantar pressure reductions with an RCW with and without modification for DRFUs.

Methods: This within-participant, repeated measures study included 16 participants with plantar neuropathic DRFUs. Walking peak plantar pressures at DRFU sites were measured for four conditions: post-operative boot (control condition), RCW alone, RCW with 20 mm of felt adhered to an orthosis, and RCW with 20 mm of felt adhered to the foot.

Results: Compared to the control condition, the greatest amount of peak plantar pressure reduction occurred with the RCW with felt adhered to the foot (83.1% reduction, p < .001). The RCW with felt adhered to the foot also offered greater peak plantar pressure reduction than the RCW alone (51.3%, p = .021) and the RCW with felt adhered to an orthosis (31.4%, p = .009).

Conclusion: The largest offloading effect recorded was with the RCW with felt adhered to the foot. High-quality randomised trials are now needed to evaluate the effectiveness of this device for healing DRFUs.

Keywords: Diabetic foot; Felt padding; Foot ulcer; Kinetics; Offloading; Orthotic devices; Plantar pressure; Pressure; Removable cast walker.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing financial interests or personal relationships that could have influenced the work reported in this journal article.

Figures

Fig. 1
Fig. 1
Conditions assessed in the study: a Postoperative footwear with the lining removed (the control), b RCW alone, c and d RCW with 20 mm of felt padding adhered to an orthosis (RCW with felt to orthosis), e–g RCW with 20 mm of felt padding adhered to the foot (RCW with felt to foot)
Fig. 2
Fig. 2
Comparison of mean peak plantar pressures for the control and three removable cast walkers (RCWs) – error bars are standard errors and horizontal lines at top of graph indicate statistically significant differences between two conditions
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376(24):2367–2375. doi: 10.1056/NEJMra1615439. - DOI - PubMed
    1. Boulton AJM. The pathway to foot ulceration in diabetes. Med Clin North Am. 2013;97(5):775–790. doi: 10.1016/j.mcna.2013.03.007. - DOI - PubMed
    1. Ribu L, Hanestad BR, Moum T, Birkeland K, Rustoen T. A comparison of the health-related quality of life in patients with diabetic foot ulcers, with a diabetes group and a nondiabetes group from the general population. Qual Life Res. 2007;16(2):179–189. doi: 10.1007/s11136-006-0031-y. - DOI - PubMed
    1. International Diabetes Federation . IDF Diabetes Atlas. 9. Brussles: International Diabetes Federation; 2019. - PubMed
    1. Driver VR, Fabbi M, Lavery LA, Gibbons G. The costs of diabetic foot: the economic case for the limb salvage team. J Am Podiatr Med Assoc. 2010;100(5):335–341. doi: 10.7547/1000335. - DOI - PubMed