Orthotic management of the neuropathic foot: An interdisciplinary care perspective

Christopher Robinson*, Matthew J. Major, Charles Kuffel, Kevin Hines, Pamela Cole

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Background: Clinical management of the patient with neuropathic foot is becoming commonplace in orthotic clinics worldwide. The presentations that can result from neuropathic foot are diverse, requiring clinicians to understand the pathomechanics of ulceration, infection, and Charcot joint arthropathy to provide effective interventions. Objectives: The purpose of this clinical perspective is to provide a review of the literature regarding clinical concepts associated with orthotic management of neuropathic foot. Study design: Literature review and clinical case study. Methods: Relevant literature were reviewed and summarized, and a clinical case study synthesizing reviewed concepts was presented. Results: Given the multifactorial nature of the neuropathic foot, treatments must be multifaceted and patient-specific to effectively address the underlying disease processes. While systemic issues such as peripheral arterial disease are treated by physicians, local issues such as foot deformity are managed by orthotists. Orthotic interventions commonly include custom footwear to reduce the risk of ulceration through creation of a protective environment or targeted plantar offloading. Patient and caregiver education to encourage management compliance is equally as important to ensure successful treatment. Conclusion: Patients with neuropathic foot benefit from an interdisciplinary care approach which engages physicians, wound care practitioners, and orthotists to treat and manage systemic and local problems. Addressing this pathology through interdisciplinary care may positively affect the patient's health status while lowering associated healthcare costs through improved treatment efficacy.

Original languageEnglish (US)
Pages (from-to)73-81
Number of pages9
JournalProsthetics and orthotics international
Volume39
Issue number1
DOIs
StatePublished - Feb 2015

Keywords

  • Diabetes
  • Lower limb orthotics
  • Orthotics
  • Skin
  • The diabetic foot
  • Wound management

ASJC Scopus subject areas

  • Health Professions (miscellaneous)
  • Rehabilitation

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