Pedorthic research in Australia is a small but growing field of exploration. Australian pedorthists are increasingly contributing to the health care knowledge-base through collaboration with local and international researchers and undertaking their own projects. Robust health research within an Australian context benefits the community, health care system and the pedorthic profession.

Below are some examples of Australian pedorthists’ involvement in recent research:

Diabetes-related foot disease (DFD) typically refers to foot ulceration or infection in people with diabetes, which arises from risk factors including peripheral neuropathy, peripheral arterial disease (PAD), and foot deformity [1]. Diabetes-related foot ulceration (DFU) is recognised globally as a leading cause of hospitalisation and amputation [1].

New Australian Guidelines for diabetes-related foot disease

Last year, Diabetes Feet Australia and the Australian Diabetes Society established a national multi-disciplinary expert working group to develop new Australian guidelines on managing diabetes-related foot disease (the previous guidelines were published in 2011). Six panels were formed to create six distinct Australian DFD guidelines (or chapters). Chapter guidelines include prevention, offloading, infection, PAD, wound healing and wound classification. Pedorthist and PAA member Karl-Heinz Schott (CPedCM Au) belongs to the prevention group that has developed the first Australian evidence-based guidelines for the prevention of diabetes-related foot ulceration. The draft prevention guideline can be found here.

Diabetic Foot Australia guideline on footwear for people with diabetes

The effectiveness of footwear to prevent re-ulceration of chronic foot wounds and recognition of the crucial role pedorthists play in managing diabetic foot disease are highlighted in Diabetes Feet Australia’s 2018 study “Diabetic Foot Australia guideline for people with diabetes.” Karl-Heinz Schott (CPedCM Au) was a member of this team, which included leading local and international diabetic and high risk foot researchers in podiatry, human movement, rehabilitation, vascular surgery and wound management.

Collaborative Interdisciplinary Diabetes High Risk Foot Services (HRFS) Standards

Evidence has shown that interdisciplinary High Risk Foot Services (HRFS) can improve outcomes for people with diabetes-related foot ulceration [2]. The Collaborative Interdisciplinary Diabetes High Risk Foot Services (HRFS) Standards were developed by the National Association of Diabetes Centres (NADC): Foot Network, which comprised an executive group, working party and consultation committee. Sayed Ahmed (CPedCM Au), pedorthist at the Nepean Hospital High Risk Foot Clinic and PAA member, was part of the working party. The Standards identify timely access to a pedorthist as a requirement for HRFS to attain gold standard accreditation in Australia.

Footwear and insole design features that reduce neuropathic plantar forefoot ulcer risk in people with diabetes: a systematic literature review

Literature reviews provide valuable synthesis and analysis of previous research on a specific topic. Pedorthist Sayed Ahmed (CPedCM Au), a doctoral candidate in the School of Health and Human Sciences at Southern Cross University, conducted a systematic literature review in 2019. Sayed and his research team summarised and evaluated the evidence for the effectiveness of footwear and insole features in preventing diabetes-related foot ulceration through forefoot offloading in people with diabetic neuropathy.

Mobile Apps for Foot Measurement in Pedorthic Practice: Scoping Review

New and emerging technologies allow for exciting opportunities to find new foot health and foot care solutions by clinicians and researchers. PAA member pedorthists Sayed Ahmed (CPedCM Au) and Craig Laird (CPedCM Au) were involved in a recent scoping review by Ashad Kabir of Charles Sturt University that evaluated the effectiveness of smartphone apps in measuring feet. The study sought to determine the apps’ potential as commercial tools for foot care health professionals. It also assessed their viability to assist in measuring feet for custom shoes. Finally, the review explored the apps’ capacity to enhance individuals’ awareness of foot health and hygiene to prevent foot-related problems.

Biomechanical effects of sensorimotor orthoses in adults with Charcot-Marie-Tooth disease

Pedorthists Karl-Heinz Schott (CPedCM Au) and our own PAA President Katrin Wegener (CPedCM Au) were part of the research team for a study published in 2016 which investigated the use of foot orthoses in the management of Charcot Marie Tooth disease (CMT). CMT is an inherited neurological disorder affecting the peripheral nerves and causes slow progressive muscle weakness, foot deformity and difficulty walking. People with CMT commonly require orthotic devices to maintain everyday mobility and prevent injury. The study explored the effects of sensomotoric orthoses on in-shoe and lower limb biomechanics in adults with CMT.

Sources

[1] Zhang, Y., van Netten, J.J., Baba, M. et al. (2021). Diabetes-related foot disease in Australia: A systematic review of the prevalence and incidence of risk factors, disease and amputation in Australian populations. Journal of Foot and Ankle Research, 14(8) https://doi.org/10.1186/s13047-021-00447-x

[2] National Evidence-Based Guidelines on Prevention, Identification and Management of Foot Complications in Diabetes (Part of the Guidelines on Management of Type 2 Diabetes) (2011). Retrieved from https://baker.edu.au/-/media/documents/impact/diabetes-foot-guidelines/baker-institute-foot-complications-full-guideline.pdf