3/24/2024 0 Comments Podiatry tuning fork frequencyThe use of appropriate footwear is particularly important for diabetic patients due to the presence of impaired sensation and poor peripheral perfusion. Turning: patients with peripheral neuropathy can find turning difficult and they may look down at their feet whilst turning due to impairment of sensation and proprioception.Steps: high-stepping may indicate the presence of foot drop.Stance: a broad-based gait may be associated with advanced peripheral neuropathy to increase stability.Speed : gait speed may be reduced significantly in patients with advanced peripheral neuropathy.Patients with diabetic foot disease are often at an increased risk of falls so make sure to remain close to the patient during the assessment so that you are able to intervene if required.Īsk the patient to walk to the end of the examination room and then turn and walk back whilst you observe their gait paying attention to: The development of foot drop is also more common in diabetic patients, which can result in a high-stepping gait. Patients with peripheral neuropathy may demonstrate a conservative gait strategy in which their walking speed is reduced and their foot stance is broadened. Peripheral neuropathy associated with diabetic foot disease can result in the development of an abnormal gait. The dorsalis pedis pulse can be located over the dorsum of the foot, lateral to the extensor hallucis longus tendon, over the second and third cuneiform bones.Palpate the pulse to confirm its presence and then compare pulse strength between the feet.The posterior tibial pulse can be located posterior to the medial malleolus of the tibia.Absence of peripheral pulses is suggestive of peripheral vascular disease. Palpate the posterior tibial and dorsalis pedis pulse to briefly assess peripheral perfusion. A cool and pale limb is indicative of poor arterial perfusion.In healthy individuals, the lower limbs should be symmetrically warm, suggesting adequate perfusion.Place the dorsal aspect of your hand onto the patient’s lower limbs to assess and compare temperature: Venous guttering: veins that have very little blood within them due to poor blood supply to the limb, hence the “guttered” appearance.Foot calluses: often caused by an abnormal gait and/or poorly fitting footwear.Hair loss: occurs due to chronic impairment of tissue perfusion in PVD.Scars: may indicate previous surgical procedures (e.g.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |