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Careful Casting Will Help To Remove The Possibility Of Pressure Points Which ...

Careful casting will help to remove the possibility of pressure points which may rub and cause ulceration or pain
Describe the pathomechanics involved in common congenital and acquired disorders of the foot and relate these to podiatric biomechanics.
Kinetic Theory of Foot Disorders.
The kinetic theory of foot disorders is closely allied to the kinematic models insofar as the former describes foot disorders in terms of work, power and movement whereas the latter model describes the same in terms of motion velocity and position. Alterations in these parameters are believed to reduce the stresses generated in the tissues that are responsible for the overuse syndromes that can be associated with abnormal foot function.

The model suggests that treatment should ideally focus on prevention of abnormal compensation movements, reduction in kinetic stresses by appropriate kinetic alterations, reducing the forces that are needed to establish the windlass mechanism and changing pressure on the plantar mechanoreceptors.


The Clinical Hypothesis.
(See notes at top)

Dependant Variables.
(See notes at top)
Extraneous variables.
(See notes at top)
Organnismic variables.
(See notes at top)

Identifying the 'at risk patient' and relative impact of diabetes, arthritis and vascular disorders on the foot. Whilst giving preventative healthcare information and participating in ongoing care.
Diabetes.
Diabetes mellitus is a multisystem disease process which primarily involves the malregulation of sugar levels in the body. A patient with diabetes is at severe risk of developing long term multisystem complications. (Sheehan P 2002)

With specific regard to the feet, the major complications are primarily vascular and neurological in aetiology. Progressively impaired circulation through the process of atherosclerosis is a common finding, particularly in the older patient and the patient with Type 1 diabetes. Neuropathy presenting with patches of numbness, parasthesiae and impaired proprioception are the other common associations with the condition (Reiber G E 2002). Clearly a patient presenting with such symptoms must be promptly evaluated referred and screened by checking either a random blood sugar, a urine sugar level or an HbA1 level (Mayfield J A et al. 1998)

In terms of pathophysiology, we note that diabetes mellitus causes its clinical manifestations by virtue of its ability to produce both macrovascular and microvascular complications. The former includes the atherosclerotic processes affecting the larger blood vessels in the body and present with either coronary artery disease (presenting to the podiatrist as angina or shortness of breath when walking) or peripheral vascular disease (presenting to the podiatrist as reduced pedal pulses, poor peripheral circulation or intermittent claudication).


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