Effectiveness of Insoles Provided to Patients With Diabetes. A Longitudinal Randomized Controlled Study in Gothenburg
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Purpose
Introduction: Insoles and shoes are frequently prescribed to prevent foot ulcers in patients at risk of diabetes. A combination of neuropathy and foot deformities raises the risk from 1% to between 4-7% according to the Swedish National Board of Health and Welfare, Guidelines Diabetes Care 2010. Preventative care, which includes foot care, annual inspection of the feet, education and prescription of insoles in combination with well fitting shoes are supposed to decrease the risk of ulcers and prevent amputation. Further research is, however, needed to evaluate the effectiveness of these commonly prescribed insoles. The aim of this study is to compare three different types of insoles with respect to pressure distribution. Every 6 months follow-up is assessed until 24 months is reached.
| Condition | Intervention |
|---|---|
|
Diabetic Foot Neuropathy Quality of Life |
Other: Custom made insoles 35 shore Other: Prefabricated insoles Other: 55 shore Custom made insole |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Effectiveness of Insoles Provided to Diabetic Patients at Risk to Develop Ulcers |
- In shoe plantar pressure measurement [ Time Frame: up to 24 months ] [ Designated as safety issue: No ]
- Gait analysis [ Time Frame: every 6 months until 24 months is reached ] [ Designated as safety issue: No ]Optical tracking system with skin-mounted markers
- Health related quality of life [ Time Frame: every 6 months until 24 months is reached ] [ Designated as safety issue: No ]
- Cost and cost analysis [ Time Frame: 24 month ] [ Designated as safety issue: No ]Calculation of costs for orthopaedic appliance in studied population
| Enrollment: | 114 |
| Study Start Date: | January 2008 |
| Study Completion Date: | July 2012 |
| Primary Completion Date: | February 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Prefabricated insoles
Prefabricated insoles with support in medial arch and metatarsal pad. A 2 mm top layer of cushioned material.
|
Other: Prefabricated insoles
Prefabricated insoles
Other Name: Bauerfeind GloboTec® 312750501400
|
|
Experimental: Custom made insoles 35 shore
Custom made insoles formed over an individual cast positive. 35 shore of hardness in material Ethyl Vinyl Acetate
|
Other: Custom made insoles 35 shore
Insoles in Ethyl Vinyl Acetate (EVA) manufactured over an individual positive cast.
|
|
Experimental: 55 shore Custom made insoles
Custom made insoles formed over an individual cast positive. 55 shore of hardness in material Ethyl Vinyl Acetate
|
Other: 55 shore Custom made insole
Insoles in Ethyl Vinyl Acetate (EVA) manufactured over an individual positive cast.
|
Detailed Description:
Patients included in the study were randomized into 3 different groups. Group number 1 and 2 got custom made insoles out of EVA (Ethyl Vinyl Acetate) with different hardness 35 and 55 shore respectively. Group nr 3 got prefabricated insole with support of the medial arch and in the forefoot. The top layer was covered with a 2 mm cushioned material, 25 shore, made out of microcellular urethane. All patients were recommended to wear good walking shoes with a semi rigid outer sole and stable heel counter. One and the same technician made the casting and fabricated the insoles as well as delivered the devices. Deliverance occured 2-3 weeks after the first visit.
At deliverance base line measurement was assessed.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion criteria:
- First time visitor to Dept of Prosthetics & Orthotics
- Diabetes
- Age > 18 year
- Be able to walk independently
- Be able to read and understand Swedish
Exclusion Criteria:
- Ulcers
Contacts and Locations| Sweden | |
| Lundbergs Laboratory for Orthopaedic Research | |
| Gothenburg, Sweden, 413 45 | |
| Study Chair: | Roy Tranberg, PhD | Lundbergs laboratory for Orthopaedic Research |
More Information
No publications provided
| Responsible Party: | Ulla Hellstrand Tang, Certified Prosthetist & Orthotist, Sahlgrenska University Hospital, Sweden |
| ClinicalTrials.gov Identifier: | NCT01663519 History of Changes |
| Other Study ID Numbers: | VGFOUGSB-9725 Regional R&D |
| Study First Received: | August 9, 2012 |
| Last Updated: | November 28, 2012 |
| Health Authority: | Sweden: Regional Ethical Review Board |
Keywords provided by Sahlgrenska University Hospital, Sweden:
|
Diabetic foot Offloading Prevention Orthotics |
Additional relevant MeSH terms:
|
Diabetic Foot Diabetic Angiopathies Vascular Diseases Cardiovascular Diseases Foot Ulcer Leg Ulcer |
Skin Ulcer Skin Diseases Diabetes Complications Diabetes Mellitus Endocrine System Diseases Diabetic Neuropathies |
ClinicalTrials.gov processed this record on May 23, 2013