The effect of exercises and insoles on the feet in leprosy patients
DOI:
https://doi.org/10.1590/1809-2950/18003026032019Keywords:
Leprosy, Orthotic Devices, Exercise, Photogrammetry, RehabilitationAbstract
The purpose of this study is to analyze the effects of using customized insoles and leg and foot exercises on the feet of patients with neuropathy caused by leprosy. Thirty volunteers diagnosed with leprosy were assigned to one of three groups: (1) Exercise group (n=10): performed exercises for the intrinsic muscles of the foot; (2) Insole group (n=10): used insoles to correct foot positioning; (3) Insole and Exercise group (n=10): used insoles and performed an exercise routine. The results of the treatments were analyzed with photogrammetry using the Alcimagem® and AutoCAD® programs. Left hindfoot posture changed after treatment in the Exercise and Insole groups (hindfoot, pre versus post <0.001). We also found that combining exercise and insoles did not alter the alignment of the feet during the study’s evaluation period (customized insoles and exercises, pre versus post <0.05), which suggests that follow-up for more than four months may be needed. The left hindfoot’s alignment can be changed with supervised exercises and the use of insoles.
Downloads
References
World Health Organization. Global leprosy: update on the 2012
situation. Weekly Epidemiological Record. 2013;88(35):365-80.
World Health Organization. Global leprosy strategy 2016-2020:
accelerating towards a leprosy-free world. 2016 [cited 2017
June 2]. Available from: https://bit.ly/2bB7J1R.
World Health Organization. Global leprosy update, 2015: time
for action, accountability and inclusion. Weekly Epidemiological
Record. 2016;(91)35:405-20.
Brasil. Ministério da Saúde. Prevalência de hanseníase. 2012
[cited 2017 June 2]. Available from: https://bit.ly/2RXKntC
World Health Organization. Enhanced global strategy for
further reducing the disease burden due to leprosy (plan
period: 2011-2015). 2009 [cited 2015 Dec. 15]. Available from:
Cordeiro TL, Barros ARSB, Foss NT, Frade MAC. Prospective
evaluation of leprosy patients wearing insole. J Neurol Neurosci.
;6:1-5. doi: 10.21767/2171-6625.S10008
Slin FJ, Keukenkamp R, Schie CH, Faber WR, Nollet F.
Foot impairments and limitations in walking activities in
people affected by leprosy. J Rehabil Med. 2011;43(1):32-8.
doi: 10.2340/16501977-0625
Tang SF, Chen CP, Lin SC, Wu CK, Chen CK, Cheng SP. Reduction
of plantar pressures in leprosy patients by using custommade shoes and total contact insoles. Clin Neurol Neurosurg.
;129(Suppl. 1):S12-5. doi: 10.1016/S0303-8467(15)30005-6
Brasil. Ministério da Saúde. Manual de prevenção de
incapacidades. Brasília, DF: Ministério da Saúde; 2008 [cited
June 4]. Available from: https://bit.ly/2XvfBhC
Cheung JTM, Zhang M. Parametric design of pressurerelieving foot orthosis using statistics-based finite element
method. Med Eng Phys. 2008;30(3):269-77. doi: 10.1016/j.
medengphy.2007.05.002
Veen NHJ, Mcnamee P, Richardus JH, Smith WCS. Costeffectiveness of interventions to prevent disability in leprosy:
a systematic review. PLoS ONE. 2009;4(2):e4548. doi: 10.1371/
journal.pone.0004548
Warren G. The foot in leprosy: lessons for diabetes. In: Boulton
AJM, Connor H, Cavanagh PR. The foot in diabetes. Chichester:
John Wiley & Sons; 2007. p. 345-362.
Schie CHM. A review of the biomechanics of the diabetic
foot. Int J Low Extrem Wounds. 2005;4(3):160-70.
doi: 10.1177/1534734605280587
Lee E, Cho J, Lee S. Short-foot exercise promotes quantitative
somatosensory function in ankle instability: a randomized
controlled trial. Med Sci Monit. 2019;25:618-26. doi: 10.12659/
MSM.912785
Wim Brandsma J. Rehabilitation of leprosy-affected people:
an overview. Clin Dermatol. 2016;34(1):66-9. doi: 10.1016/j.
clindermatol.2015.10.015
Iunes DH, Bevilaqua-Grossi D, Oliveira AS, Castro FA, Salgado
HS. Comparative analysis between visual and computerized
photogrammetry postural assessment. Braz J Phys Ther.
;13(4):308-15. doi: 10.1590/S1413-35552009005000039
Iunes DH, Carmélia BJ, Rocha CBJ, Borges NCS, Marcon CO,
Pereira VM, et al. Self-care associated with home exercises
in patients with type 2 diabetes mellitus. PLoS ONE.
;9(12):e114151. doi: 10.1371/journal.pone.0114151
Brasil. Ministério da Saúde. Manual de adaptações de palmilhas
e calçados. Brasília, DF: Ministério da Saúde; 2008 [cited 2019
June 5]. Available from: https://bit.ly/2YxLaE9
Hamill J, Knutzen KM, Derrick TR. Biomechanical basis of human
movement. USA: Lippincott Williams and Wilkins; 2015.
Kapandji AI. The physiology of the joints: lower limb. London:
Churchill Livingstone; 2010.
Staheli LT, Chew DD, Corbett MT. The longitudinal arch. A survey
of eight hundred and eighty-two feet in normal children and
adults. J Bone Joint Surg Am. 1987;69(3):426-8.
Gonçalves SD, Sampaio RF, Antunes CMF. Predictive factors
of disability in patients with leprosy. Rev Saúde Publica.
;43(2):267-74. doi: 10.1590/S0034-89102009000200007
Kim SH, Ahn SH, Jung GS, Kim JH, Cho YW. The effects of
biomechanical foot orthoses on the gait patterns of patients
with malalignment syndrome as determined by three
dimensional gait analysis. J Phys Ther Sci. 2016;28(4):1188-
doi: 10.1589/jpts.28.1188
Hutchins S, Bowker P, Geary N, Richards J. The biomechanics
and clinical efficacy of footwear adapted with rocker profiles –
evidence in the literature. Foot. 2009;19(3):165-70. doi: 10.1016/j.
foot.2009.01.001
Seboka G, Alert PS. Cost-effective footwear for leprosy control
programmes: a study in rural Ethiopia. Lepr Rev. 1996;67:208-16.
Slim FJ, Schie CH, Keukenkamp R, Faber WR, Nollet F. Increased
plantar foot pressure in persons affected by leprosy. Gait
Posture. 2012;35(2):218-24. doi: 10.1016/j.gaitpost.2011.09.010
Guimarães CQ, Teixeira-Salmela LF, Rocha IC, Bicalho LI,
Sabino GS. Factors related to compliance with biomechanical
insole use. Braz J Phys Ther. 2006;10(3):271-7. doi: 10.1590/
S1413-35552006000300004
Boulton, AJM. Diabetic foot – what can we learn from
leprosy? Legacy of Dr. Paul W. Brand. Diabetes Metab Res
Rev. 2012;28(Suppl. 1):3-7. doi: 0.1002/dmrr.2230.
Downloads
Published
Issue
Section
License
Copyright (c) 2019 Fisioterapia e Pesquisa
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
