Diabetic Foot Clinical Trial
Official title:
Sealed Therapeutic Shoe vs. Total Contact Cast as Treatment of Diabetic Foot Ulcers: a Multicenter RCT
Total contact casts (TCCs) are effective treatment of plantar diabetic foot ulcers because
they effectively offload the ulcer and are non-removable, resulting in high adherence to
using the device. However, TCCs are not widely used in clinical practice because they
negatively impact gait and daily activities. A new treatment concept was invented, sealed
therapeutic shoe, where a shoe with a custom-made insole offloads the ulcer, and the shoe is
rendered irremovable to be worn day and night, like a TCC.
In this multicenter randomized controlled trial (RCT), 150 participants will be recruited and
randomized to two treatment arms: TCC or sealed therapeutic shoe. The primary outcome is
ulcer healing, secondary outcomes include (but are not limited to) skin complications,
glycemic control, body mass index, gait function, balance, quality of life, physical
activity, and health economics.
Data for the primary outcome of 112 participants are needed but the aim is to recruit 150, if
possible within a reasonable time frame, to take drop-out into account.
Participants are randomized (blocked randomization, stratified for ulcer site and study
center) to either treatment with a sealed therapeutic shoe or total contact cast.
Each participant will be assessed by a cast technician during the treatment period (for ulcer
healing and skin complications) and be assessed by a physiotherapist on five occasions: at
baseline, approximately 4 weeks into treatment and 1, 6 and 12 months after treatment end. On
these occasions the physiotherapist will perform different tests (gait, balance, ankle
strength and flexibility, bone mass density in heel bone, etc) and participants will answer
questionnaires and have their physical activity measured for 7 days with an activity monitor.
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