healix offload catalogue the ultimate in diabetic footwear

healix offload catalogue the ultimate in diabetic footwear Reed Medical Ltd: Thwaites Close, Shadsworth Business Park, Blackburn, Lancashire, United Kingdom BB1 2QQ. Tel +44 (0)1254 503333 E-mail admin@reedmedical.co.uk Website www.reedmedical.co.uk

Data was gathered from eight pairs of U.K. commercially available diabetic footwear and compared to healix footwear. the evidence based choice healix why healix? The healix range of diabetic footwear has been specifically designed to minimise the risk of plantar ulceration of the Neuropathic diabetic foot. healix footwear uses Reed Medical s unique patented dual axis rigid rocker sole design, Reed Medical s innovative SafeSeam upper technology and Reed Medical s front line Polyurethane insole system. why rigid rockers? Recent published research indicates that a rigid rocker sole design is more effective in offloading the mechanical stresses and strains experienced under the neuropathic foot. The healix dual axis rocker places the rocker point of the shoe behind the anatomical axis of the metatarso-phalangeal joints of the foot, reducing the force and pressure at this high ulcer risk area. why upper construction? The neuropathic diabetic foot is susceptible to abrasion and friction from the upper of the shoe. safeseam construction locates any necessary upper seams in areas of the foot where the risk of abrasion is at an absolute minimum. Leather uppers are constructed using the lap seam method ensuring even thickness and pressure. Upper linings uses the safeseam closed seam method to create seams with no variation in upper thickness or internal surface pressure making the internal surface of the shoe smooth and free from potential seam hazards. why front line polyurethane insoles? Published research indicates that insoles made from polyurethane offer exceptionally good shock attenuation and pressure relieving characteristics and have the advantage in that polyurethane resists compression set or bottoming out. Reed Medical s front line PU insoles are contoured to accommodate the anatomical shape of the foot and are removable to allow for the insertion of custom made orthoses. We recommend custom insoles manufactured from P.U. block. why 3 widths and 2 depths? Reed Medical understands that the foot comes in all shapes and sizes, that s why we offer a range of three width fittings to accommodate foot width variation and two depth options to allow for the use of custom made orthoses. the concern According to the World Health Organisation, the global diabetic population will exceed 366 million by 2030. In the UK, the National Health Service spends 1,000,000 (1 million) per hour on treating Type 1 and Type 2 diabetes. This is approximately 10% of the total annual NHS budget. According to The International Consensus on the Diabetic Foot, 85% of all diabetes related lower extremity amputations are preceded by a Diabetic foot ulcer. Approximately 15% of the UK diabetic population will experience a foot ulcer, with between 2 and 4% of the UK diabetic population being treated for ulcers at any one time. Inappropriate footwear has been identified as a causative factor in the development of Diabetic plantar ulceration. Evidence in the medical literature suggests rocker soled shoes offer advantages in reducing force and pressure under the at risk neuropathic foot. the research The research and development team at Reed Medical have developed a unique twin axis rocker sole that offers the healthcare professional an evidence based alternative to current diabetic footwear. Reducing the magnitude and duration of pressure experienced under the neuropathic foot is now considered a priority for patients at risk of plantar ulceration. Footwear supplied to patients considered at risk of plantar ulceration should demonstrate design features to reduce the likelihood of the shoe becoming a causative factor in plantar ulceration development. The Reed Medical healix shoe is designed to reduce the mechanical stress under the foot compared to other shoe designs. To establish the effectiveness of the patented healix design, in-shoe pressure data was gathered from eight pairs of U.K. commercially available diabetic footwear and compared to healix footwear. the evidence Using the Tekscan pressure measurement system, data was collected from a single subject walking on a treadmill at 4 kilometres per hour. A comparison of the results between the healix shoe and eight randomly selected diabetic shoes, indicate that the healix design reduces the peak pressure and the pressure time duration under the heel, the metatarsal heads and the toes. healix footwear from Reed Medical represents a significant development in footwear design for the neuropathic foot. healix footwear demonstrates lower under foot pressures and forces in areas of high risk of ulcer formation. By reducing the possibility of a first ulcer and the incidence of re-ulceration, Reed Medical believe that healix footwear will make a major contribution to reducing the cost burden of treating neuropathic ulceration and significantly reduce ulceration rates within the global diabetic population. healix. a valuable lessen page 3

external features internal features Removable, contoured, low shear polyurethane inlay Quality leather Low friction, seam-free, anti-bacterial interior safeseam construction Rim toe puff Pressure relieving padded tongue Recent studies by the REED Medical Research team indicate that Polyurethane (PU) displays superior pressure reduction and force reduction properties over Ethylene Vinyl Acetate (EVA) when used in the manufacture of foot orthoses and insoles. Total contact insoles (TCI) made from Low density P.U. (LDPU) demonstrate reduced peak force and reduced peak pressure under the heel and metatarsal areas of the foot when compared to the same insoles made from EVA. PU insoles also demonstrate a higher degree of contact area under the foot when compared to the same insoles made from EVA. Unlike EVA, PU insoles do not compress or bottom out under areas of high contact pressure and offer improved impact absorption properties, making PU insoles safer choice for the at risk foot. patented sole geometry 3 Narrow waist 3 Internal Bi-planar heel radii 3 Negative heel height 3 Minimal heel pitch Left and right indicated in braille Low impact chamfered heel High M.V.T.R rating Geometrically stable dual density sole REED Medical are now offering the manufacture of TCI in PU or the purchase of PU block to clinicians. test shoe#2 19/5/11 Default axis 60@19 20º 3º design details Rocker based on the high gear / low gear dual axis metatarsal extension model as described by Bojsen MØller (1979) Position of high gear axis placed at 60% of foot length as described by van Schie et al (2000) Dual axis high gear - low gear rocker Oeko-Tex St 100 class 3 lining Anatomical toe shape 25 Transverse medial axis perpendicular to longitudinal bisection of foot Oblique axis 25 degrees from perpendicular based on average met position 90 Sagittal plane rocker angle 20 degrees 60% 40% Negative pitch angle 3 degrees healix. a valuable lessen page 5

design validation and methodology test results healix versus 8 commonly prescribed diabetic footwear brands validation test discreet areas data processing Full foot pressure integral Kpa/sec Full foot force impulse Kg/sec 3 Compare in-shoe force and pressure values at five discreet sites. Whole Foot Avg Integral KPa/Sec 10 Whole Foot Avg Impulse Kgs/ Sec 7 3 healix vs.uk s 8 most popular Diabetic Shoes 9.5 9 8.5 6.5 6 5.5 trial methodology 3 Single subject comparison 1st Ray Metatarsal 2-5 8 7.5 7 6.5 5 4.5 4 3.5 3 43 y.o.a active male 6 3 3 80.6Kg body weight Mid foot 3 No known gait or biomechanical abnormalities Midfoot 1st Ray 3 Treadmill walking @ 4Km/Hr (1.1 mtr/sec) Rear foot Midfoot Integral Kpa/Sec 1.8 Midfoot Impulse Kgs/Sec 1.8 1st Ray Integral KPa/Sec 1.8 1st Ray Impulse Kgs/Sec 1.9 3 24 hour treadmill familiarisation 3 Footwear identity withheld from subject 3 Research 6:3 system 3 New sensors prepared and calibrated as per Tekscan recommended protocols 3 10 seconds of data collection 3 Sample frequency 50hz (500) frames Whole foot Measurements taken for Impulse Kgs/Sec and Integral Kpa/Sec Average phase of 10 steps 1st and last frames discarded Data values exported as ASCII files to Padowan Graph 4.3 software Integral and Impulse values calculated using Padowan software 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0 Mets 2-5 Mets 2-5 Integral KPa/Sec 1.6 1.4 1.2 1 0.8 0.6 Mets 2-5 Impulse Kgs/Sec 1.6 1.4 1.2 1 0.8 0.6 Rearfoot Rearfoot Integral Kpa/Sec 1.7 1.5 1.3 1.1 0.9 0.7 0.5 Rearfoot Impulse Kgs/Sec 1.9 2 2 2.1 1.7 1.5 1.3 1.1 0.9 0.7 1.8 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 1.8 1.6 1.4 1.2 1 0.8 0.6 1.9 1.7 1.5 1.3 1.1 0.9 0.7 0.5 0 0.4 0.5 healix. a valuable lessen page 7

healix test results healix footwear full foot pressure integral Kpa/sec lowry order code? Pressure Integrals kpa/sec Force Impulse kgs/sec Min % reduction Max % reduction Min % reduction Max % reduction Brogue bootee Safe-seam construction Whole foot Rear foot 1st Ray Mets 2-5 -22.62% -45.46% -15.67% -38.38% -34.34% -66.6% -58.83% -70.56% -26.67% -47.42% -16.1% -38.9% -34.33% -68.23% -57.06% -70.75% mean % reduction kpa/sec mean % reduction kgs/sec mean % reduction Whole foot Rear foot 1st Ray Mets 2-5 -28.48% -56.03% -37.27% -54.47% -30.5% -57.82% -36.58% -54.82% rodin order code? conclusion Plain front bootee Safe-seam construction The healix shoe design has shown performance characteristics considered beneficial to the reduction of plantar ulceration when compared to other Diabetic footwear. Reduction of force and pressure under the foot are considered beneficial in ulcer risk reduction. healix. a valuable lessen page 9

healix footwear healix footwear scott order code? degas order code? Plain front 3 eyelet shoe Plain front extended 4 eyelet shoe stubbs order code? Brogue 3 eyelet shoe healix. a valuable lessen page 11

healix footwear monet order code? hockney order code? Plain front extended 5 eyelet shoe 5 eyelet trainer style shoe Available in leather only breton order code? Brogue extended 4 eyelet shoe healix. a valuable lessen page 13

healix footwear zero g footwear hirst order code? zero g ankle foot orthosis (afo) order code? Plain front casual 4 eyelet shoe. The Zero G ankle foot orthosis (AFO) is a prefabricated, offloading brace that relieves plantar surface pressure from the foot. The Zero G AFO incorporates a supple, but strong, adjustable, calf corset with leather lacers and Velcro closures. This design provides a totalcontact, hydrostatic lift of the inverted cone shape of the calf, providing up to 100 per cent offloading of the foot. The Zero G brace s patented design, with malleable metal uprights, provides a sturdy, stable substructure that transfers weight from the ground top the calf and not the foot and ankle, providing up to 100 per cent non-weight bearing. The Zero G AFO is indicated for the following conditions: Charcot foot (neuropathic joint disease) Arthritis, including Gout/Gouty arthritis Osteochondritis Dissecans Heel and metatarsal ulceration Diabetic foot ulcers Fractures of the distal tibia, talus or calcaneous Pre or post-surgical intervention of the mid and hind foot Crushing injuries of the mid and hind foot Any condition in which unweighting of the foot or ankle is needed Technical Details The Zero G AFO comes in two components, the calf lacer and the AFO base. fagan order code? Trainer boot. Available in leather only calf lacer Apply with an adjustable Velcro closure system for ease of donning/doffing the brace Anterior tongue protection to complete the 360-degree lacer One Smartknit seam-free sock for soft interface Infinitely adjustable leather corset on the brace structure with Velcro fasteners afo base Half inch donning pad to ensure a repeatable off-loading process Double-action ankle joints for assist/resist adjustment One inch memory foam foot pad to cushion any pressure applied to plantar surface of the foot Footplate pad made from ¼ plastazote Adjustable, padded foot cover encases and protects the foot Universal for left or right fitting Sizing Measurements of the calf circumference and the foot length and taken to determine proper sizing. The lacer and AFO Base sizes of the Zero G AFO can be interchanged for a correct fit. calf lacer Product Code Size Calf Circumference ZGAL-100S Small 9.5-12.5 ZGAL-100M Medium 13-15.5 ZGAL-100L Large 19-22.5 afo base Product Code Size Foot Length ZGA-100S Small 8.19-9.02 ZGA-100M Medium 9.17-9.84 ZGA-100L Large 10.91-11.75 ZGA-100XL X-Large 10.91-11.75 ZGA-100XXL XX-Large 11.77-12.25 healix. a valuable lessen page 15

loadstars footwear loadstars footwear fore foot off-loader universal fit for left or right foot order code PO100 heel off-loader universal fit for left or right foot order code PO400 Black only Sizes 35-47 Low 34mm heel reduces leg length discrepancy trauma and maintains stability Velcro fasten Complete with dual density 8 degree negative pitch insole Black only Sizes S 35-36-37 M 38-39-40 L 41-42-43 XL 44-45-46-47 Removable heel protector Soft PU insole Velcro fasten ALLUX LESS. TOES 17 37 30 32 36 25 52 50 55 65 57 26 MED. FOREF AT. FOREF 25 37 40 55 60 42 75 55 22 ALLUX LESS. TOES 27 167 187 87 32 52 25 22 27 47 82 25 32 70 135 135 130 115 55 25 32 35 47 60 37 115 140 140 130 122 110 67 22 40 62 72 45 40 67 80 55 kpa 300.00 MED. FOREF AT. FOREF 92 90 92 85 87 80 52 MID. FOOT 220.00 37 37 37 45 60 67 62 32 54 67 62 32 150.00 37 57 50 45 57 70 52 17 85 90 80 82 80 52 kpa 50 72 84 86 77 45 100.00 30 55 57 55 57 72 62 300.00 77 135 150 157 147 132 70 112 165190192 182160 92 60.00 40.00 MID. FOOT 15 55 65 62 60 72 42 30 80 90 80 80 75 60 220.00 150.00 MED. HEEL 127 152147167 92 AT. HEEL 17 85 90 80 82 80 52 30 80 90 80 80 75 60 17 42 52 47 40 100.00 60.00 17 42 52 47 40 40.00 MED. HEEL AT. HEEL ED. HEEL AT. HEEL forefoot and mid foot off-loader universal fit for left or right foot order code PO500 Black only Sizes 35-47 Low 22mm sole Velcro fasten Rigid rocker Complete with dual density 8 degree negative pitch insole ALLUX 27 27 LESS. TOES stability walker universal fit for left or right foot Black only Removable lateral stability inserts Low friction upper Rigid outsole with full rocker for steady mid stance Dual density 8 degree negative pitch insole Modus insole option (extra cost) Velcro fasten Sizes 35-47 order code PO700 42 62 67 80 65 62 82 95 110 115 92 40 MED. FOREF AT. FOREF 27 57 72 100 105 95 82 15 42 70 80 67 25 57 70 50 15 55 75 52 MID. FOOT 30 47 55 22 22 60 70 65 65 15 kpa 300.00 220.00 150.00 100.00 Recommended for Tibiotarsal, subastragaloid arthrodesis Charcot foot Corrective distal osteotomy Calcaneal fractures Mid foot and forefoot ulcers Comparable to Gold Standard TCI s 47 142 175 150 162 132 40 60.00 117 216 240250 240 219 87 127 92 212212 212 MED. HEEL AT. HEEL 40.00 healix. a valuable lessen page 17

loadstars insoles modus off loading insole universal fit for left or right foot order code? Triple density insole with removable inserts for specific pressure reduction Anti bacterial and antifungal properties Ideal for plantar surface ulcer pressure relief Sizes 35/36 37/38 39/40 41/42 43/44 45/46 47/48 dual density 8 degree negative pitch insole universal fit for left or right foot order code? Transfers pressure from the forefoot to the rearfoot Sizes 35/36 37/38 39/40 41/42 43/44 45/46 47/48 healix. a valuable lessen