Priority 2 from the Foot Health PSP

UNCERTAINTY: What can people who are categorised as 'high risk' do to prevent foot health problems (e.g. people with poor circulation, diabetes or other conditions that could cause serious foot problems)?  (JLA PSP Priority 2)
Overall ranking 2
JLA question ID 0092/2
Explanatory note It is known that people who have conditions such as diabetes, Peripheral Arterial disease or significant neurological deficit. Such conditions can predispose them to serious life and limb threatening complications. Prevention of serious complication therefore is a high priority for high quality research, to reduce the risks of deterioration and so that, patients/carers, clinicians and researchers can understand and implement the most effective preventative strategies.

CD000990 – Lane et al (2017). Exercise for intermittent claudication. Evidence showed that exercise did not improve ankle brachial pressure indices, amputation rate or mortality. Some evidence to show that it did improve pain free/max walking distance and quality of life outcomes. CD005263 – Hageman et al (2018). Supervised exercise therapy ‘v’ home based exercise therapy ‘v’ walking advice for intermittent claudication. Moderate to high quality evidence for SET in improvement of measured walking distance. No clear evidence of difference between HBE/ WA. More evidence required for quality of life & functional outcomes and longer term follow up needed.

Health Research Classification System category  Generic health relevance
Extra information provided by this PSP
Original uncertainty examples Is it inevitable that there will be foot health problems due to type 2 diabetes, and can they be prevented? ~ What are the optimum approaches to maintaining foot health in the prescence of peripheral neuropathy? ~ ... is there anything to show how effective podiatry is in helping to prevent or raise awareness of vascular lower limb problems?"
Submitted by Healthcare professional x 4, Patient x 28
PSP information
PSP unique ID 0092
PSP name Foot Health
Total number of uncertainties identified by this PSP. 30  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 26 September 2019