评估活动性Charcot神经骨关节病患者皮肤温度的全接触铸造(TCC)去除后达到温度稳定的最佳时间。

IF 2.2 3区 医学 Q1 ORTHOPEDICS
Justin Bradley, Mollie Rumble, Jennifer Wong, Ming Yii, Michelle R Kaminski
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引用次数: 0

摘要

背景:在Charcot神经骨关节病(CNO)中,四肢之间的皮肤温差用于监测疾病进展和支持安全退出固定。尽管临床广泛使用皮肤测温仪,但缺乏关于拆除固定装置(如全接触铸型)后最佳温度稳定期的证据。本研究旨在探讨去除TCC后达到温度稳定的最佳时间,以评估活性CNO的皮肤温度。方法:在2年的时间里,这项受试者内重复测量研究从澳大利亚墨尔本的一个大都市高风险足部服务中心招募了12名接受TCC治疗的活动性CNO成人。如果参与者患有双侧CNO、活动性足部溃疡、炎症性足部疾病(如痛风)、外周动脉疾病或下肢截肢,则被排除在外。在温度控制的房间里,去除TCC和对侧鞋类后,使用红外温度计记录皮肤温度。从基线到90分钟,每隔10分钟在每只脚的10个解剖位置记录温度。配对样本t检验或Wilcoxon符号秩检验探讨了10个时间点上每个解剖部位的温度稳定性。结果:平均年龄为55.1 (SD, 8.9)岁,男性占75.0%,83.3%患有2型糖尿病。所有参与者都有周围神经病变,很大一部分有足部溃疡史(75.0%)。CNO的平均持续时间为2.9 (SD, 1.7)个月,以1期(91.7%)居多,影响跗跖关节(58.3%)和跗骨中关节(83.3%)。总的来说,夏可(铸型)足和对侧(非铸型)足的皮肤温度稳定了40分钟。结论:这是第一个探索在评估活性CNO的皮肤温度时实现温度稳定的最佳时间的研究。40分钟似乎是达到热平衡的适当休息时间。虽然这种方法可以提高皮肤测温的准确性,但在临床实践中,时间周期可能并不总是可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Optimal Time Period to Achieve Temperature Stabilisation After Total Contact Cast (TCC) Removal for Assessing Dermal Temperatures in Active Charcot Neuro-Osteoarthropathy.

Optimal Time Period to Achieve Temperature Stabilisation After Total Contact Cast (TCC) Removal for Assessing Dermal Temperatures in Active Charcot Neuro-Osteoarthropathy.

Optimal Time Period to Achieve Temperature Stabilisation After Total Contact Cast (TCC) Removal for Assessing Dermal Temperatures in Active Charcot Neuro-Osteoarthropathy.

Optimal Time Period to Achieve Temperature Stabilisation After Total Contact Cast (TCC) Removal for Assessing Dermal Temperatures in Active Charcot Neuro-Osteoarthropathy.

Background: Dermal temperature differentials between limbs are used to monitor disease progression and support safe withdrawal of immobilisation in Charcot neuro-osteoarthropathy (CNO). Despite the wide clinical use of dermal thermometry, there is a lack of evidence on the optimal temperature stabilisation period after removal of immobilisation devices, such as total contact casts (TCCs). This study aimed to investigate the optimal time period to achieve temperature stabilisation post removal of TCC for assessing dermal temperatures in active CNO.

Methods: Over a 2-year period, this within-subjects repeated measures study recruited 12 adults with active CNO treated with TCC from a metropolitan high-risk foot service in Melbourne, Australia. Participants were excluded if they had bilateral CNO, an active foot ulcer, an inflammatory foot condition (e.g., gout), peripheral artery disease or major lower limb amputation. In a temperature-controlled room, dermal temperatures were recorded using an infrared thermometer after removal of TCC and contralateral footwear. Temperatures were recorded at 10-min intervals from baseline to 90 min at 10 anatomical locations on each foot. Paired samples t-tests or Wilcoxon signed-rank tests explored temperature stabilisation at each anatomical site across the 10 time points.

Results: Mean age was 55.1 (SD, 8.9) years, 75.0% were male and 83.3% had type 2 diabetes. All participants had peripheral neuropathy and a large proportion had history of foot ulceration (75.0%). The average duration of CNO was 2.9 (SD, 1.7) months, with most classified as stage 1 (91.7%), affecting the tarsometatarsal joints (58.3%) and midtarsal joints (83.3%). Overall, dermal temperatures had stabilised by 40 min for the Charcot (casted) foot and contralateral (non-casted) foot.

Conclusions: This is the first study to explore the optimal time period to achieve temperature stabilisation when assessing dermal temperatures in active CNO. Forty minutes appears to be an appropriate resting time to reach thermal equilibrium. Although this approach may improve the accuracy of dermal thermometry, the time period may not always be feasible in clinical practice.

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来源期刊
CiteScore
4.50
自引率
10.30%
发文量
83
审稿时长
>12 weeks
期刊介绍: Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.
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