Dear All,

I'm a physiotherapist working in the area of infectious diseases. Being a
relatively young clinician, I've a recurrent clinical question that has been
festoring in my mind but unresolved. I hope your expertise may illuminate my
troubled mind.

I've had many persons with diabetes being admitted for their chronic plantar
diabetic ulcers that has resisted healing to some extent. Many a times,
they're being referred by the medical officers to us for exercise advise and
management. The weight bearing status of these group of persons has been a
big question on my mind. Nurse clinicians has recommended non-weight bearing
status for a unspecified but prolonged period. The local podiatrists hasn't
offered much in terms of constructive advise and management. Is it really
necessary to off-load the ulcer area for a long period of time or is an
alternative partial weight bearing solution a much better idea, with the
idea that this will not create larger pressure loading in the 'good leg'
compared to the non-weight bearing option. Are there any forms of footwear
that will allow sufficient weight distribution on the affected foot yet
encourages the healing process to take place?

Eagerly awaiting a suggestion,
Chee-Wee, Tan
Physiotherapist

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