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Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review
Patients with diabetic peripheral neuropathy (DPN) usually have reduced somatosensory information and altered perception in feet and ankles. Somatosensory information acts as feedback for movement control and loss of somatosensation leads to altered plantar pressure patterns during gait and stance....
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087551/ https://www.ncbi.nlm.nih.gov/pubmed/33452959 http://dx.doi.org/10.1007/s11154-020-09619-9 |
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author | Horstink, Koen Andre van der Woude, Lucas Henricus Vincentius Hijmans, Juha Markus |
author_facet | Horstink, Koen Andre van der Woude, Lucas Henricus Vincentius Hijmans, Juha Markus |
author_sort | Horstink, Koen Andre |
collection | PubMed |
description | Patients with diabetic peripheral neuropathy (DPN) usually have reduced somatosensory information and altered perception in feet and ankles. Somatosensory information acts as feedback for movement control and loss of somatosensation leads to altered plantar pressure patterns during gait and stance. Offloading devices are used to reduce peak plantar pressure and prevent diabetic foot ulcers. However, offloading devices can unfortunately have negative effects on static and dynamic balance. It is important to investigate these unwanted effects, since patient with DPN already are at high risk of falling and offloading devices could potentially increase this risk. The aim of this systematic review is to investigate the effects of plantar offloading devices used for ulcer prevention on their role in static and dynamic balance control in patients with DPN. PubMed and Embase were systematically searched using relevant search terms. After title selection, abstract selection, and full-text selection only five articles could be included for further analysis. Two articles included static balance measurements, two articles included dynamic balance measurements, and one article included both. Results suggested that static balance control is reduced when rocker bottom shoes and different insole configurations are used, however, toe-only rockers showed less evidence for reduced static balance control. There was no evidence for reduced dynamic balance control in combination with offloading devices. However, these results should be interpreted with care, since the number of studies was very small and the quality of the studies was moderate. Future research should evaluate balance in combination with different offloading devices, so that clinicians subscribing them are more aware of their potential unwanted consequences. |
format | Online Article Text |
id | pubmed-8087551 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-80875512021-05-05 Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review Horstink, Koen Andre van der Woude, Lucas Henricus Vincentius Hijmans, Juha Markus Rev Endocr Metab Disord Article Patients with diabetic peripheral neuropathy (DPN) usually have reduced somatosensory information and altered perception in feet and ankles. Somatosensory information acts as feedback for movement control and loss of somatosensation leads to altered plantar pressure patterns during gait and stance. Offloading devices are used to reduce peak plantar pressure and prevent diabetic foot ulcers. However, offloading devices can unfortunately have negative effects on static and dynamic balance. It is important to investigate these unwanted effects, since patient with DPN already are at high risk of falling and offloading devices could potentially increase this risk. The aim of this systematic review is to investigate the effects of plantar offloading devices used for ulcer prevention on their role in static and dynamic balance control in patients with DPN. PubMed and Embase were systematically searched using relevant search terms. After title selection, abstract selection, and full-text selection only five articles could be included for further analysis. Two articles included static balance measurements, two articles included dynamic balance measurements, and one article included both. Results suggested that static balance control is reduced when rocker bottom shoes and different insole configurations are used, however, toe-only rockers showed less evidence for reduced static balance control. There was no evidence for reduced dynamic balance control in combination with offloading devices. However, these results should be interpreted with care, since the number of studies was very small and the quality of the studies was moderate. Future research should evaluate balance in combination with different offloading devices, so that clinicians subscribing them are more aware of their potential unwanted consequences. Springer US 2021-01-16 2021 /pmc/articles/PMC8087551/ /pubmed/33452959 http://dx.doi.org/10.1007/s11154-020-09619-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Horstink, Koen Andre van der Woude, Lucas Henricus Vincentius Hijmans, Juha Markus Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review |
title | Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review |
title_full | Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review |
title_fullStr | Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review |
title_full_unstemmed | Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review |
title_short | Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review |
title_sort | effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: a systematic review |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087551/ https://www.ncbi.nlm.nih.gov/pubmed/33452959 http://dx.doi.org/10.1007/s11154-020-09619-9 |
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