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Neoprene footwear in the neuropathic foot. Is it contraindicated?

Discussion in 'Diabetic Foot & Wound Management' started by AmandaPod, Aug 24, 2015.

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  1. AmandaPod

    AmandaPod Welcome New Poster


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    Hi All,

    Is the use of Neoprene footwear contraindicated in the neuropathic foot and why?

    I recall being taught many years ago that it was a big no no to accommodate the neuropathic foot into a shoe with a neoprene upper and a few of my colleagues agree with this viewpoint, however I am at a loss to find any evidence to support this.

    We have a local medical grade footwear supplier who regularly attempts to accommodate patients into this style of footwear and personally I have seen mixed results when it has been used.

    Any insight would be greatly appreciated.
    Thanks
     
  2. Craig Payne

    Craig Payne Moderator

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    There is no evidence and I can not think of a reason why it would not be.
    It will trap perspiration, but I do not see that as a big issue.
    I also would have thought that a neoprene upper is very accommodating, so this would have been a good thing.
    What reasons are they giving for agreeing?
     
  3. AmandaPod

    AmandaPod Welcome New Poster

    Thanks Craig

    It was one of those things I can remember being told a long time ago but never really questioned. I have never strictly adhered to it and as I mentioned, I've seen mixed results when it has been used in this patient population (but then I've seen mixed results with all forms of medical grade footwear).

    Every once and a while it pops up and most recently some colleagues were questioning it's use and seemed quite sure that it was contraindicated so I finally decided to search for some evidence to support the theory (and couldn't find any).

    From memory I think it had something to do with heat and moisture transfer but then it's also been suggested to me that it has something to do with proprioception and anterior slippage in the shoe (??).
     
  4. thekwie

    thekwie Active Member

    Hi Amanda,
    My two cents worth

    "From memory I think it had something to do with heat and moisture transfer but then it's also been suggested to me that it has something to do with proprioception and anterior slippage in the shoe (??)."

    Most accommodative neoprene footwear is not entirely neoprene (they either have leather heel cups and lacing/velcro - thus negating the anterior slippage. And I would always recommend good socks (preferably Bamboo fibre) for neuropathic patients, so this kind of negates the moisture transfer issue.

    I do remember hearing something in uni vaguely along the same lines, but it seemed to me far more sensible to put a patient in something with better accommodative properties.
     
    Last edited: Aug 25, 2015
  5. Boots n all

    Boots n all Well-Known Member

    Few things to consider here.

    Firstly, the quality brands are using "Ventoprene" not just Neoprene, the ventoprene is neoprene with small holes every 3mm so moisture cant build up, should be no more and maybe even less moisture build up than for a leather upper?

    You need to pick the client for the shoe.
    The neoprene/ventoprene upper is very forgiving but there is little to no support or protection. This type of footwear tends to suit the Bunion, hammer toe type feet and best where the client doesnt do a lot of walking, IMO, as they are not highly durable.

    We often get asked by Podiatrists and P&O's to supply this type of product, l dont always agree with it, but l will fill the prescription written by the refer.

    IMO l prefer not to put these shoes on the client with Diabetes, l would rather a well fitted leather upper shoe, control and protection being the aim.

    Most of the footwear l see provided by hospital based Podiatrists for clients with diabetes are these neoprene/ventoprene type footwear.
     
  6. AmandaPod

    AmandaPod Welcome New Poster

    Thanks thekwie and David

    I figured there had likely been an improvement over the last decade or so in the materials being used, therefore the shoes are being prescribed more, so thank you for confirming that David.

    I agree, there shouldn't be a 'one size fits all' approach and interesting that your local HRFC's are prescribing them for the majority of their patients. It's the opposite where I am.
     
  7. Boots n all

    Boots n all Well-Known Member

    l think they are supplying them as the "safest" option, certainly not the best option IMO.

    If your not happy with your local MGF supplier fitting these type of shoes to your clients, buy a packet of Timtams and go over for a coffee and a chat.:drinks and explain your concerns. Cant hurt, unless one of you have Diabetes ;)
     
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