Jones, AD, De Siqueira, J orcid.org/0000-0002-1653-2832, Nixon, JE et al. (3 more authors) (2022) Plantar shear stress in the diabetic foot: A systematic review and meta-analysis. Diabetic Medicine, 39 (1). e14661. ISSN 0742-3071
Abstract
Aims
Diabetic foot ulceration (DFU) is a multifactorial process involving undetected, repetitive trauma resulting in inflammation and tissue breakdown. Shear stress forms a major part of plantar load, the aim of this review is to determine whether elevated shear stress results in ulceration.
Methods
A systematic review of the Ovid Medline, EMBASE, CINAHL and Cochrane library databases was performed. Studies involving patients with diabetes who underwent plantar shear stress assessment were included. The primary outcome was plantar shear stress in patients with diabetes who had a current/previous DFU compared with those with no prior ulceration. Meta-analysis was performed comparing shear stress between those with a current or previous DFU and those without, and those with diabetes and healthy controls.
Results
The search strategy identified 1461 potentially relevant articles, 16 studies met the inclusion criteria, involving a total of 597 patients. Comparing shear stress between the current/previous DFU group and those without: Standardised mean difference (SMD) 0.62 (95% CI −0.01 to 1.25), in favour of greater shear stress within the DFU group, p = 0.05. Comparing shear stress between people with diabetes and healthy controls: 0.36 (95% CI −0.31 to 1.03), in favour of greater shear stress within the diabetes group, p = 0.29.
Conclusion
This review suggests that that patients with diabetes and a history of ulceration exhibit greater shear stress than their ulcer-free counterparts. This strengthens the premise that development of systems to measure shear stress may be helpful in DFU prediction and prevention.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 Diabetes UK. This is the peer reviewed version of the following article: Jones, AD, De Siqueira, J, Nixon, JE, Siddle, HJ, Culmer, PR, Russell, DA. Plantar shear stress in the diabetic foot: A systematic review and meta-analysis. Diabet Med. 2021; 00:e14661, which has been published in final form at https://doi.org/10.1111/dme.14661. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. |
Keywords: | diabetic foot; diabetic foot ulcer; pathophysiology; plantar shear stress |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Mechanical Engineering (Leeds) > Institute of Engineering Systems and Design (iESD) (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Discovery & Translational Science Dept (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Clinical Trials Research (LICTR) (Leeds) |
Funding Information: | Funder Grant number EPSRC (Engineering and Physical Sciences Research Council) EP/R041776/1 |
Depositing User: | Symplectic Publications |
Date Deposited: | 10 Sep 2021 08:58 |
Last Modified: | 29 Jul 2022 14:38 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/dme.14661 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:178025 |