Effects of Rehabilitation Using Therapeutic Sandals for Patients With Chronic Limb-Threatening Ischemia

Abstract

Background: Studies of off-loading devices for chronic limb-threatening ischemia (CLTI) are scarce. We investigated (1) the effect of the application of early therapy sandals on changes in the Clinical Frailty Scale (CFS) scores of patients with CLTI before and after hospitalization, and (2) adverse events such as wound deterioration and reamputation.

Methods and Results: We retrospectively analyzed the cases of 51 patients (51 limbs) with toe amputation after revascularization and compared 2 groups: patients who did not apply any load during the off-loading duration and focused on resistance training (the ‘usual rehabilitation’ group), and those who used therapeutic sandals and performed walking and aerobic exercises with partial off-loading from an early stage (the ‘orthotic’ rehabilitation group). The before-to-after hospitalization change in the CFS score was 0 (−1, 0) in the usual rehabilitation group, and 0 (0, 1) in the orthotic rehabilitation group (P=0.002), a significant difference. There were no significant between-group differences in wound healing duration (usual rehabilitation group, 48 [19,76.5] days; orthotic rehabilitation group, 41 [27.5,78.8] days) or reamputation rate (usual rehabilitation group, 5 [22%]; orthotic rehabilitation group, 3 [11%]).

Conclusions: The early postoperative use of therapeutic sandals tended to shorten the duration of complete off-loading after toe amputation due to CLTI and to help maintain CFS scores throughout the hospitalization duration. It was also shown to have a minimal impact on treatment delay and reamputation.