Background
Neurovascular assessments are conducted routinely by podiatrists as a means of screening for peripheral arterial disease and peripheral neuropathy, to reduce the risk of foot ulceration, infection and amputation. Assessments commonly used to derive clinical data include the palpation of pulses, and the use of Doppler ultrasounds, systolic toe pressure sensors, monofilaments and tuning forks. Whilst it is common practice to use these assessments to monitor foot health, this data has the potential to illuminate a much more holistic perspective of a person’s health status.
Methods
Fifty participants (19 male, 31 female; 71.78±9.64 years) were recruited using random sampling to participate in a foot health promotion event at the Charles Sturt University Community Engagement and Wellness Centre. Basic neurovascular assessments were completed by student practitioners to determine each patient’s neurological, arterial and venous status. The Foot Health Status Questionnaire was also completed by all participants. Age, monofilament results and absolute toe pressures were recorded as continuous values, while all other data was categorical. Statistical interactions were identified using Pearson’s Chi-square.
Results
Those participants who reported ability to lift or carry bags of shopping, showed a statistically significant relationship with adequate vibration sensation (p=0.04), a palpable tibialis posterior pulse (p=0.04) and a triphasic Doppler assessment (p<0.00). The ability to get up from a sitting position (p<0.00) and independent showering and dressing (p=0.04), shared a significant association with a 10/10 monofilament score. It was also noted that a palpable tibialis posterior pulse shared a significant relationship with never having foot pain (p<0.00) aching feet (p=0.01), and no limitation in occupational capacity (p=0.02).
Discussion
These findings show significant interactions between standard neurovascular assessments and a range of activities of daily living. While the authors are mindful that these findings are correlational, not causational, a global view of neurovascular assessment may allow patient results to be viewed more holistically. Determining the ability to detect and heal tissue damage will not change, however, neurovascular findings may be used to stimulate further discussion about the patient as a whole, not just the presenting condition.