Dell’Erba, Martina (2020) Development of a Foot Diagram as a Diagnostic Instrument with Clinical Applicability in the Care for Diabetic Entrapment Neuropathies of the Lower Extremities. thesis, Medicine.
Full text available on request.Abstract
Background: Distinguishing entrapment neuropathy from distal sensorimotor polyneuropathy in diabetic patients with lower limb neuropathic symptoms is important, since lower extremity nerve decompression (LEND) surgery can restore sensation and decrease pain. A foot diagram might aid this diagnostic process and might be implemented in follow-up after surgery. Objective: To determine the reliability of the foot diagram and to analyse its applicability in the assessment of lower entrapment neuropathy and of LEND surgery. Methods: 30 foot diagrams of patients who underwent unilateral LEND surgery were evaluated by 5 raters. Intra- and inter-rater reliability of the foot diagram were calculated using kappa statistics. The applicability of the foot diagram was evaluated by Cohen’s kappa on the rater agreement, by comparing the results with the real post-operative data. Results: A Cohen’s kappa of 0.803 (p < 0.0001) and Fleiss’ kappa of 0.204 to 0.613 (p < 0.0001) were found respectively for intra- and inter-rater reliability. A Cohen’s kappa of 0.625 (p = 0.029) was found on the applicability of the foot diagram as a tool to determine the condition of a foot at follow-up. No statistically significant results were found for two other parameters assessed. Conclusion: A “moderate” to “substantial” reliability of the foot diagram for superficial peroneal nerve and tibial nerve were found. Significant agreement on the applicability of the foot diagram as a tool to be implemented at follow-up was established. These findings indicate that the foot diagram is a promising aid to the diagnosis and follow-up of diabetic entrapment neuropathies.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | van Wijk, Dr. M.E. and Fakkel, Drs. T.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 08 Sep 2023 11:43 |
| Last Modified: | 08 Sep 2023 11:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3676 |
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