Circulation Problems In Feet

Circulation Problems in Feet: Insights from Recent Research

Diabetic Foot Circulation Issues

Peripheral Circulation and Rehabilitation

Diabetes can lead to severe foot problems, including infections, ulcers, and an increased risk of amputation due to nerve or vascular damage. Buerger's exercise is a common rehabilitation method aimed at improving blood circulation in the lower limbs. A novel optical system has been developed to non-invasively monitor changes in foot blood circulation before and after long-term Buerger's exercise. This system uses a radial basis function neural network to classify healthy and diabetic groups based on changes in relative total hemoglobin (HbT) concentration and tissue oxygen saturation (StO2). The results indicate significant differences in HbT concentration and StO2 between healthy subjects and diabetic foot patients, with improvements noted after long-term rehabilitation.

Hypoxia and Abnormal Blood Flow

Necrotic ulcers are a dangerous complication of diabetic foot syndrome, often resulting from peripheral vascular disease (PVD) and peripheral neuropathy. Research shows that diabetic feet with abnormal blood flow have a significantly reduced reserve of circulation and oxygen supply compared to both diabetic and non-diabetic controls. This disturbed circulation, even in the absence of PVD, correlates with decreased oxygen supply, which is crucial in the pathogenesis and treatment of necrotic ulcers.

Low-Intensity Laser Therapy

Low-intensity laser irradiation has been shown to improve skin circulation in patients with diabetic microangiopathy. A study using infrared thermography demonstrated that a single session of low-intensity laser irradiation significantly increased skin temperature, indicating improved blood circulation. This method could be a promising non-invasive treatment to enhance microcirculation in diabetic patients.

Microvascular Disturbances and Ischemia

In diabetic patients, neuropathy, peripheral arterial occlusive disease, and microvascular disturbances contribute significantly to foot problems. These disturbances lead to severely reduced capillary circulation and impaired hyperaemic responses, resulting in chronic capillary ischemia. Traditional measurements of peripheral blood pressure, such as systolic ankle and toe blood pressure, often fail to detect these microvascular issues. Therefore, combining these measurements with local tissue perfusion assessments, such as transcutaneous oxygen tension, is recommended for a more accurate evaluation of peripheral tissue perfusion in diabetic patients.

Circulatory Issues in the Elderly

A study of elderly patients revealed that circulatory problems are a major cause of foot pain and disability, accounting for 31% of cases. This highlights the importance of addressing circulatory issues in the elderly to improve their quality of life.

General Insights on Diabetic Foot

Diabetic foot syndrome involves complex anatomical and functional changes, affecting 40-60% of diabetes patients. High blood glucose levels impair arterial and capillary blood circulation, leading to angiopathy and neuropathy. These conditions can cause gangrene, characterized by swelling, skin color changes, and increased tissue temperature.

Blood Flow and Tissue Nutrition

In patients with atherosclerotic peripheral vascular disease, blood flow in apparently ischemic feet is weakly pulsatile, but the resting total foot blood flow volume is higher than normal. This suggests that localized tissue perfusion failure, rather than overall regional blood flow insufficiency, is responsible for ischemic or anoxic nutritional skin lesions.

Exercise Interventions

Leg exercises have been shown to significantly improve blood circulation in the feet of diabetes mellitus patients. A study demonstrated that regular leg exercises not only enhance blood circulation but also strengthen leg muscles and improve joint mobility, which can help prevent complications such as diabetic ulcers.

Conclusion

Circulation problems in the feet, particularly among diabetic patients, are a significant health concern. Various interventions, including Buerger's exercise, low-intensity laser therapy, and regular leg exercises, have shown promise in improving blood circulation and preventing complications. Accurate assessment of peripheral tissue perfusion and addressing microvascular disturbances are crucial for effective management and treatment of these conditions.

Summary

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