Effectiveness of Manual Manipulation With EPAT on Ankle Dorsiflexion and Dynamic Plantar Pressure



Status:Recruiting
Conditions:Orthopedic, Orthopedic
Therapuetic Areas:Orthopedics / Podiatry
Healthy:No
Age Range:21 - 65
Updated:4/21/2016
Start Date:October 2014
End Date:October 2017
Contact:Jinsup Song, D.P.M., Ph.D.
Email:jsong@temple.edu
Phone:215-625-5369

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Do Physical Manipulation Exercises With EPAT Improve Ankle Dorsiflexion and Reduce Dynamic Plantar Forefoot Pressure in Diabetic Subjects With Equinus?: A Pilot RCT

Diabetic foot complications are a common and costly problem. Excessive plantar pressures due
to foot deformities and/or limited ankle dorsiflexion, especially in the presence of
peripheral neuropathy, can predispose subjects with diabetes for diabetic foot ulcers.
Achilles tendon lengthening surgery has shown to delay or prevent recurrence of diabetic
foot ulcers.

Studies have shown that Shockwave Therapy (EPAT - Extracorporeal Pulse Activation
Technology) was effective in treating subjects with chronic heel pain and Achilles
tendonitis with no serious side effects. EPAT, therefore, may allow diabetic patients with
ankle equinus to perform more effective stretching exercises and may prevent recurrence of
diabetic foot ulcers.

The purposed of this RCT is to compare effectiveness of manual manipulation with EPAT versus
manual manipulation alone on ankle dorsiflexion and dynamic plantar pressure in at-risk
subjects with a history of diabetic foot ulcer.


Inclusion Criteria:

- Men and women between the ages of 21 to 65, inclusive

- Diabetes, either type 1 or 2

- Ankle equinus (< 0º passive ankle dorsiflexion with knee extended)

- Forefoot plantar hyperkeratosis (callus)

- Able to walk independently without the use of walking aids (cane, crutches, or
walker)

- Able to understand the information in the informed consent form and willing and able
to comply with study-related procedures

Exclusion Criteria:

- Previous history of ankle-foot surgery or amputation

- no active lower extremity skin ulcers

- Peripheral vascular disease (non-palpable pedal pulses or ankle brachial index <0.8)

- Not willing or able to make required visits

- Nursing or pregnant

- Not willing or able to follow procedures specified by protocol and/or instructions of
the study personnel, including discontinuation of icing, NSAIDs and natural
anti-inflammatory agents (such as Arnica)
We found this trial at
1
site
927 West Berks Street
Philadelphia, Pennsylvania 19107
Principal Investigator: Jinsup Song, D.P.M., Ph.D.
Phone: 215-625-5369
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Philadelphia, PA
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