what-when-how
In Depth Tutorials and Information
6
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Sensory loss.
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Foot pain and origin: ischaemic, arthritic, inflammatory, neuropathic.
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Measure pain (use Likert scale for walking, standing and at rest).
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Skin: tissue viability, ulcers, lesions, infections (presence of
dressings).
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Suitability of hosiery.
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Suitability of current footwear including history of footwear usage
and preferences; wear marks.
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Foot structure and function: overall shape, function, areas of
increased pressure.
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Gait, function and mobility.
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Assessment of the need for functional or accommodative foot
orthoses.
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Patient's understanding of the planned intervention and agreement.
As with any assessment, there needs to be a structured and systematic
approach so that essential factors are not left out. It is important to
ascertain the patient's shoe-wearing habits as the footwear that they wear
to their clinical appointment may not be the footwear that is worn the
majority of the time; for example, they may have to wear specialist protec-
tive footwear at work or they may be at home mostly and wear slippers
the majority of the time. Also, footwear may be chosen specifically for the
appointment as they know that their usual footwear would be deemed
unsuitable by the practitioner. Information about when, where and how
often shoes are bought can be very useful as a baseline for the assess-
ment of footwear and for a foundation on which to build specific advice.
Key
Concept
Ascertain if the footwear worn to the consultation is that usually worn
for the majority of the time.
It is important to ascertain the patient's footwear history, such as past
successes, likes, dislikes and requirements for employment (for example,
safety footwear). Other factors that can be tactfully explored here are the
patient's financial circumstances and preferences regarding body image.
Patient choice has to be respected by the practitioner and provides a
foundation on which future changes in footwear habits can be based.
Key
Concept
Patient choice has to be respected by the practitioner and provides a
foundation on which future changes in footwear habits can be based.
