Role of experimental socks in the care of the high-risk diabetic foot. A multicenter patient evaluation study. American Group for the Study of Experimental Hosiery in the Diabetic Foot.

OBJECTIVE: To assess the acceptability of specially designed socks to provide satisfactory pressure relief in the insensitive, high-risk, diabetic foot. We have conducted a longitudinal multicenter patient evaluation study to assess the acceptability of such hosiery in neuropathic diabetic patients. RESEARCH DESIGN AND METHODS: A group of 86 neuropathic diabetic patients (69 males, 14 with type I diabetes) with a mean age of 63 yr (range 34-85 yr), and a diabetes duration of 16 yr (range 1-45 yr) participated in the study. Peripheral vascular disease was present in 28 (33%) patients, previous foot ulceration in 39 (44%) patients, and active ulceration was present in 11 (13%) patients. All patients were provided with three pairs of specially designed socks and 80 patients with extra-depth shoes. Evaluation and foot examination were performed at 3 and 6 mo. RESULTS: Socks were worn for a mean of 6 days/wk (range 1-7 days/wk). Patient satisfaction evaluated at both visits was good or very good in 85%, average in 12%, and poor in 3% of patients. Ten ulcers healed during this period, and seven new ulcers occurred. Intention to continue wearing the socks, most or all of the time, was expressed by 84% of patients. CONCLUSIONS: We conclude that the experimental socks have a high level of patient satisfaction when worn with suitable shoes, and may be an acceptable and inexpensive addition to existing methods of protecting the high-risk insensitive diabetic foot.

Comparison of cotton and acrylic socks using a generic cushion sole design for runners.

A longitudinal single-blind study was conducted to test the friction blister prevention properties of synthetic acrylic socks in a generic construction. This study serves as a comparison with the authors' previous work comparing acrylic and cotton socks in a patented padded construction. Twenty-seven long-distance runners provided data regarding dampness, temperature, friction blister incidence, severity, and size. Two different socks were tested; each was identical in every aspect of construction except the fiber content. One test sock was composed of 100% synthetic acrylic fibers, and the other was composed of 100% natural cotton fibers. These results were unsuccessful at demonstrating any superiority of cotton or acrylic fibers when knitting produced a generic "cushion sole" sock. The superiority of acrylic fibers has thus far been demonstrated only when sock knitting provides adequate anatomical padding [corrected].

Orthoses for athletic overuse injuries. Comparison of two component materials.

Forty recreational and professional athletes were followed in this prospective study comparing the acceptability and effectiveness of two orthotic component materials commonly used in sports medicine. TL-2100 SF (semiflexible) was compared to 4.0-mm thick polypropylene in six different subjective categories. The subjects were able to perceive a significant difference in favor of TL-2100 SF in the categories of weight, resilience and springiness, and overall comfort of the orthosis. The subjects were also able to perceive physical differences between these two component materials, which had previously been confirmed in laboratory studies.

Friction blisters and sock fiber composition. A double-blind study.

A longitudinal double-blind study was conducted to determine the effect of sock fiber composition on the frequency and size of blistering events in long-distance runners. Thirty-five long-distance runners participated in this study. Two different socks were tested, which were identical in every aspect of construction except fiber composition. One test sock was composed of 100% acrylic fibers, and the other test sock was composed of 100% natural cotton fibers. The results showed that acrylic fiber socks were associated with fewer blistering events and smaller blisters (mm2), when compared directly to cotton fiber socks.

Shin muscle activity and sports surfaces. An electromyographic study.

Twelve human subjects were studied to determine the effect of three different floor surfaces on the medial shin musculature during stationary running. Electromyographic equipment, gated by an accelerometer affixed to the subject's shin, was used to separate the impact (eccentric) phase from the propulsive (concentric) phase of each running step. Excessive eccentric muscle activity has been associated with increased muscle damage, and recent investigations have linked medial tibial shin pain with actual structural damage to the muscle-fascial attachments to the posteromedial aspect of the tibia. Therefore, this study tends to verify the previous assumption that running on hard, noncompliant sport surfaces would predispose running and dancing athletes to shin muscle damage and resultant pain.

Aerobic Dance Injuries: A Retrospective Study of Instructors and Participants.

In brief: In this study shoes, floor types, and individual physical differences were evaluated for their effects on aerobic dance injuries. The injury frequency was 75.9% for instructors and 43.3% for students. The shin was the most common site of injury in both groups. Overall, 60% of the injuries in the student group and 52% of injuries in the instructor group occurred below the knee. Most injuries were not debilitating, and few required medical treatment. The authors concluded that resilient but stable floor surfaces, proper shoes, and moderating the frequency of participation can prevent injuries in aerobic dance.

Functional instability of the ankle and the role of neuromuscular control: a comprehensive review.

A review of current knowledge of the clinical syndrome of functional ankle instability is presented. Recent evidence has demonstrated that the majority of patients with functional instability of the ankle do not have mechanical hypermobility of the ankle joint. Functional instability of the ankle results from a loss of neuromuscular control. Components of neuromuscular control include proprioception, muscle strength, muscle reaction time, and postural control. Proprioceptive deficits lead to a delay in peroneal reaction time, which appears to be a peripheral reflex. Proprioception and eversion muscle strength improve with the use of passive supportive devices. Balance and postural control of the ankle appear to be diminished after a lateral ankle sprain and can be restored through training that is mediated through central nervous mechanisms. Methods of detecting deficits in neuromuscular control are presented along with rehabilitation techniques to treat functional instability of the ankle.