Diabetic Foot symptoms, and how Orthotics can help make life and mobility better www.customorthotic.ca

1. Orthotic Management of the Diabetic Foot The Orthotic Centre At St. Joseph’s Healthcare, Hamilton Linda LaaksoB.Sc.C.O.(c) Certified Orthotist www.customorthotic.ca

2. Orthoses Any device that is used to support, align, protect or correct a body part. www.customorthotic.ca

3. The Certified Orthotist a specialized healthcare professional who measures, designs, fabricates, fits, or services orthoses, and/or assists in the formulation of orthoses. Governed by Canadian Board for Certification of Prosthetists and Orthotists (CBCPO) www.customorthotic.ca

4. Certified Orthotist and the Wound Team - Taking the pressure off Treat the Cause – assess and modify situations where pressure may be increased”* * “Pathway to Assessment/Treatment of Pressure Ulcers” in the RNAO Best Practice Recommendations www.customorthotic.ca

6. Diabetic Autonomic Neuropathy – What can be done? Skin care Moisturize Wear shoes that fit well www.customorthotic.ca

8. Diabetic Motor Neuropathy – What can be done? For Muscle Imbalance – Foot Orthoses (FO) For Drop foot – Ankle Foot Orthosis (AFO) www.customorthotic.ca

9. Sensory Neuropathy – Loss of Protective Sensation Cannot feel foreign objects in shoes Not aware to change gait to protect feet Ill fitting shoes (too tight) www.customorthotic.ca

11. Always wear appropriate footwear

12. Daily foot check

13. Proper shoe fittingwww.customorthotic.ca

16. Orthopaedic Shoes

17. Cast Boot

18. Total Contact Cast (TCC)

19. Bracing www.customorthotic.ca

20. Foot Orthoses designed to correct/accommodate foot deformities usually fabricated from a plaster impression of the feet Materials selected based on the requirements of the individual www.customorthotic.ca

22. Orthopaedic shoes www.customorthotic.ca

23. Rockered bottom shoe www.customorthotic.ca

24. Cast Boot Prefabricated boot used to immobilize foot and ankle and reduce motion www.customorthotic.ca

25. Total Contact Cast (TCC) www.customorthotic.ca

27. Flexible; for drop foot

28. Rigid; provides more stability for club foot

29. Hinged; provides control with motion

30. Tubular; circumferential AFO, lined and padded

31. CROW; Charcot Restraint Orthotic Walker – total contact AFO with rubber outsole and custom insolewww.customorthotic.ca

32. CROW – Charcot Restraint Orthotic Walker Custom Long-term Total Contact Cast Made from plaster impression Removable Durable Cleanable Custom made “foot orthosis” Rockered bottom outsole Rigid ankle Total Contact   Area www.customorthotic.ca

33. Thank you! For a free copy of this presentation, please contact Linda at lindalaakso@customorthotic.ca www.customorthotic.ca