From the Guidelines
Yes, a patient can walk in a multipodous boot, but it is crucial to follow the healthcare provider's specific instructions regarding weight-bearing status and to use assistive devices to reduce pressure on the affected limb and risk of falls, as recommended by the guidelines on the diagnosis and treatment of active charcot neuro-osteoarthropathy in persons with diabetes mellitus (iwgdf 2023) 1.
Key Considerations
- The boot provides stability and immobilization to the injured area while still permitting the patient to walk with a more normal gait pattern than would be possible with traditional casts.
- Patients should wear a shoe of similar height on the unaffected foot to prevent hip and back pain from leg length discrepancy.
- The boot should be secured firmly but not too tightly, with straps typically fastened from bottom to top.
- Patients may need to use crutches or a cane initially for additional support, gradually increasing weight-bearing as tolerated and as directed by their healthcare provider.
Recommendations
- Treatment with a non-removable knee-high off-loading device should be started immediately when active CNO is suspected, and continued unless an alternative diagnosis is made, in order to prevent the development of deformity 1.
- A total contact cast (TCC) might be considered as first choice, and a knee-high walker that is made non-removable as second choice 1.
- Patients should be informed that it can take many months before the disease goes into remission, and offloading should be continued for four to 6 weeks after the clinical signs of active CNO have resolved and the patient is diagnosed as in remission 1.
Important Notes
- The guidelines emphasize the importance of early immobilization and reduced weight-bearing on the diseased foot to prevent the development of deformity and to promote healing 1.
- The use of assistive devices, such as crutches or a cane, can help reduce pressure on the affected limb and risk of falls, and should be considered as part of the treatment plan 1.
From the Research
Ability to Walk in a Multipodous Boot
- There are no research papers to assist in answering this question, as the provided studies focus on pain management and the efficacy of various medications, rather than the use of multipodous boots or mobility aids 2, 3, 4, 5, 6.
- The studies discuss the comparison of analgesics such as ibuprofen and paracetamol for treating pain after soft tissue injuries 2, pharmacologic therapy for acute pain 3, and the efficacy of these medications in various pain conditions 4, 5.
- Additionally, one study examines the effect of NSAIDs on recovery from acute skeletal muscle injury 6, but none of the studies address the specific question of walking in a multipodous boot.