Effect of charcot restraint orthotic walker three-dimensional printed sole on charcot foot ulcer / Haitham Amin Elessawy ; Supervised Amal Mohamed Abdelbaky , Adel Abdelhamid Nossier , Hassan Lotfy Ibrahim

Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Physical Therapy for Surgery

The purpose: Charcot Neuroarthropathic plantar foot ulcer result in gangrene and lower limb amputation if improperly managed. Consequently, it is a foot disorders which is a leading cause for hospitalization. Although not all foot complications can be prevented, dramatic reductions in frequency have been achieved by taking a multidisciplinary approach to patient management.The aim of the study to evaluate the therapeutic efficacy of CROW 3D printed sole as novel orthosis in comparison to the gold standard off-loading treatment; generic Charcot restraint orthotic walker in enhancing the Charcot foot ulcer surface area closure measured by image analysis processing software (ImageJ software). Subjects: sixty participants with Chronic Charcot neuroarthropathic plantar foot ulcer were randomized in a parallel group trial with concealed allocation, and assessor blinding. Participants were divided randomly into two groups, both received the same standard medical treatment. Participants in the group A (n=30) were fitted with CROW 3D printed sole. Participants in the group B (n=30) were fitted with generic CROW. Procedure: The interventions were applied for 12 weeks. participants{u2019} peak vertical ground reaction force was measured using Wii balance board (force platform) and the ulcer was assessed before and after fitting period of interventions by measuring ulcer surface area using image analysis processing software (ImageJ software).The results: showed that both group interventions were effective in decreasing peak vertical ground reaction force during gait that results in ulcer size reduction although, compared with the group B, the CROW 3D printed sole group had better Charcot foot plantar ulcer surface area closure healing rate with an improvement percentage 32.21% when compared with group B with an improvement percentage of 20.51% (p= 0.02 )

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