Off-loading strategies in diabetic foot syndrome-evaluation of different devices

Introduction Diabetic foot syndrome is one of the most dreaded complications in diabetes mellitus. The purpose of this study was to assess the value of different offloading devices compared to walking in barefoot condition and in normal shoes both in healthy subjects and in patients with diabetes and neuropathy. Methods Twenty patients with diabetes and polyneuropathy and ten healthy probands were included. Pedobarographic examination was performed in barefoot condition, with sneakers, postoperative shoes, AircastA (R) Diabetic Pneumatic Walker (TM) and VACOA (R) diaped. In the diabetic group, a total contact cast was additionally tested. Results The most effective reduction of force was achieved by TCC (75%) and VACOdiaped (64.3%) with the VACOA (R) diaped resulting in the most homogeneous distribution of forces all over the foot. Discussion/Conclusion A customized device like the TCC is still the most proven offloading device. However, a removable cast walker being based on vacuum pads and a cushioning sole, provides better results concerning force distribution.