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Diabetic Foot and Orthotic Management
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Diabetic Foot and Orthotic Management


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Diabetic Foot symptoms, and how Orthotics can help make life and mobility better …

Diabetic Foot symptoms, and how Orthotics can help make life and mobility better

  • so nice presentation..please send me at my e-mail
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  • That is an excellent point. There are several diseases/diagnoses that can cause peripheral neuropathy similar to diabetes. I see so many people with complications due to diabetes that it is a main concern for me. I think that I have only seen two people who have had leprosy in the 20 years that I have been practicing. Side effects from medication and alcoholism are other causes of peripheral neuropathy that I see (only once in a while though). Thanks again!
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  • I think when we talk of Diabetic foot management we should also include management foot to people affected by Leprosy because the management to me are almost the same.
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  • The right orthotic can certainly improve a persons life! Enjoyed your presentation!
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  • great information!
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  • 1. Orthotic Management of the Diabetic Foot
    The Orthotic Centre
    At St. Joseph’s Healthcare, Hamilton
    Linda LaaksoB.Sc.C.O.(c)
    Certified Orthotist
  • 2. Orthoses
    Any device that is used to support, align, protect or correct a body part.
  • 3. The Certified Orthotist
    a specialized healthcare professional
    who measures, designs, fabricates, fits, or services orthoses, and/or assists in the formulation of orthoses.
    Governed by Canadian Board for Certification of Prosthetists and Orthotists (CBCPO)
  • 4. Certified Orthotist and the Wound Team - Taking the pressure off
    Treat the Cause – assess and modify situations where pressure may be increased”*
    * “Pathway to Assessment/Treatment of Pressure Ulcers” in the RNAO Best Practice Recommendations
  • 5. Diabetic Autonomic Neuropathy – Nerve Damage
    Impairment of sweat glands
    • Dry feet
    Increased dilation of arterioles (excess of blood) and joint/tissue damage
    • Charcot Foot
  • 6. Diabetic Autonomic Neuropathy – What can be done?
    Skin care
    Wear shoes that fit well
  • 7. Diabetic Motor Neuropathy – Loss of Intrinsic Muscle
    • Muscle imbalance – “claw foot”
    Causes high pressure area at metatarsal
    heads, PIP joints and distal tips of toes.
    • Loss of ankle/foot
    dorsiflexors causes “drop foot”
  • 8. Diabetic Motor Neuropathy – What can be done?
    For Muscle Imbalance – Foot Orthoses (FO)
    For Drop foot – Ankle Foot Orthosis (AFO)
  • 9. Sensory Neuropathy – Loss of Protective Sensation
    Cannot feel foreign objects in shoes
    Not aware to change gait to protect feet
    Ill fitting shoes (too tight)
  • 10. Sensory Neuropathy – What can be done?
    • Check footwear for foreign objects
    • 11. Always wear appropriate footwear
    • 12. Daily foot check
    • 13. Proper shoe fitting
  • 14. Pressure = Force/area
    Pressure is inversely proportional to surface area that force is applied
    Force – mass x acceleration – hard to change
    • Area – can we change the size, shape or contour of the area over which the force is applied?
  • 15. What can be done to Re-distribute Pressure?
  • 20. Foot Orthoses
    designed to correct/accommodate foot deformities
    usually fabricated from a plaster impression of the feet
    Materials selected based on the requirements of the individual
  • 21. Foot Orthoses / Orthopaedic Shoes
    Additions or changes to a shoe to improve fit and or function
    • Rockered sole or buttress
  • 22. Orthopaedic shoes
  • 23. Rockered bottom shoe
  • 24. Cast Boot
    Prefabricated boot used to immobilize foot and ankle and reduce motion
  • 25. Total Contact Cast (TCC)
  • 26. Orthopaedic Bracing - Orthoses
    Made to a plaster impression of the body part
    • AFO – Ankle Foot Orthosis
    • 27. Flexible; for drop foot
    • 28. Rigid; provides more stability for club foot
    • 29. Hinged; provides control with motion
    • 30. Tubular; circumferential AFO, lined and padded
    • 31. CROW; Charcot Restraint Orthotic Walker – total contact AFO with rubber outsole and custom insole
  • 32. CROW – Charcot Restraint Orthotic Walker
    Custom Long-term Total Contact Cast
    Made from plaster impression
    Custom made “foot orthosis”
    Rockered bottom outsole
    Rigid ankle
    Total Contact   Area
  • 33. Thank you!
    For a free copy of this presentation, please contact Linda at