Alterations to plantar loading and ankle range of motion of the contralateral foot during assisted walking in patients with Type 2 Diabetes Mellitus.
Jose G Anguiano-Hernandez, Joseph W Harrington, Vijay Shivaswamy and 1 others
PMID 36055183WHAT IT FOUND
Wheeled knee walkers reduced whole-foot and forefoot loading on the healthy foot compared to crutches and walkers, while maintaining faster walking speeds and greater ankle movement.
This suggests they may better protect the non-injured foot in diabetic patients.
Key findings
01Locomotion with the wheeled knee walker produced significantly less whole-foot plantar impulse and lower peak forefoot force than normal walking, crutches, or a standard walker.
02Participants walked faster with the wheeled knee walker than with crutches or a standard walker, with differences exceeding the minimal clinically important difference.
03Ankle range of motion was greatest when using the wheeled knee walker, specifically significantly higher than when using a standard walker.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study included only 20 participants with well-controlled Type 2 Diabetes (A1c ≤ 10%) and no active foot ulcers, so results may not generalize to patients with more severe disease or active wounds. The order of walking conditions was not randomized, which could introduce fatigue or learning effects. Force measurements were influenced by gripping force on the device handles, potentially skewing body weight offloading data. The insoles only measured normal (vertical) force, not anterior-posterior or medial-lateral shear forces, which are also relevant to ulceration risk. Participants were instructed to walk for 200m or until they could not continue, but the specific reasons for early termination were not detailed.
Declared interests
The authors disclose no financial or personal relationships that could bias the work. Funding was provided by the National Institute of General Medical Sciences (NIH).
The easy way to misread this
Do not assume the WKW is superior because it offloads more body weight. The study found no significant difference in body weight offloading between the devices. The WKW's advantage appears to be in reducing the total force and time the foot spends on the ground (impulse) and improving speed, not in transferring more weight to the arms.