According to the 2016 WHO Global Report on Diabetes, the global prevalence of diabetes has reached 8.5% of the adult population, nearly double the 1980 figure, and is rising faster in middle and low income countries than in high income countries. Reduced quality of life and high morbidity and mortality associated with the disease have made it a global health priority. Orthotists direct efforts to reducing the incidence of foot ulceration and subsequent amputation that result from foot deformities associated with the disease. In our themed issue on Lower Limb Orthotics (April), a paper by Allan, Munroe and Figgins (2016)reviews our current understanding of the causes of deformity. The common belief that foot deformity is a result of motor neuropathy and atrophy is not supported by the review. Much remains to be done to enable an understanding of the aetiology of deformity and to design interventions to reduce this problem.
In systematic reviews of the medical literature, we often encounter a statement that only English language papers were included in the review. Readers are often left wondering whether there is valuable information in non-English publications that has been overlooked by the reviewers. It is reassuring to see a systematic review of Japanese language RCTs on the effectiveness of orthoses for management of knee osteoarthritis. The review by Mine, Nakayama, Milanese, and Grimmer (2016)recently published in OnlineFirst, makes a body of previously inaccessible evidence available to English language researchers and clinicians. The review supports the use of short-lever elastic coil knee braces for pain relief in walking and squatting but does not support the use of wedged foot orthoses.
Phantom limb pain affects upward of 80% of amputees to some extent. It is a distressing problem for amputees and a frustrating and intractable problem for prosthetists. Recent trials of prosthetic liners with electromagnetic shielding have produced promising results for the management of this problem. A study by Fisher, Oliver, Sedki, and Hanspal (2016) published in the current (June) issue of POI presents a placebo-controlled, double-blind crossover trial which demonstrates the potential of this approach to provide some relief for amputees.
Free access to these articles is available to eUpdate readers for six months using the links below.
Foot deformities within the diabetic foot and their influence on biomechanics: A review of the literature. Allan, J., Munro, W., & Figgins, E. (2016).
The effect of electromagnetic shielding on phantom limb pain: A placebo-controlled double-blind crossover trial. Fisher, K., Oliver, S., Sedki, I., & Hanspal, R. (2016).
The effectiveness of braces and orthoses for patients with knee osteoarthritis: A systematic review of Japanese-language randomised controlled trials. Mine, K., Nakayama, T., Milanese, S., & Grimmer, K. (2016).