Research in the Podiatry team is led by Dr Jane Lewis. Our main areas of research relate to chronic disease management and musculoskeletal disorders (MSK). We are exploring population screening of individuals for peripheral arterial disease, a powerful predictor of cardiovascular disease. Within the chronic disease arena, we are also looking at antimicrobial resistance in infected diabetic plantar foot ulcers; an increasing national problem with increasing cost implications. Our MSK research is considering proximal and distal factors in the rehabilitation of individuals with patellofemoral pain, and also minimally invasive surgery for bunions.
Research Areas
Screening for Peripheral Arterial Disease (PAD)
PAD is a cardiovascular disease that is limb threatening, but is treatable if diagnosed early enough. As PAD can often be asymptomatic, our group is working with Primary Care, Public Health Wales and the NHS to explore methods of non-invasive population screening for the disease in cardiovascular risk patients across Wales.
Work has already been completed with Medical Physics departments to validate a portable, automatic device that compares very favourably with the ultrasound Duplex scan. The group are now running two further studies. The first is screening those with diabetes and hypertension for PAD in GP practices across all 7 health boards in Wales. The second is screening those attending diabetic eye screening sessions for PAD and neuropathy; complications that could lead to limb loss if not identified early.
Antimicrobial resistance in infected diabetic foot ulcers (DFUs)
The group are working with microbiologists in the Infection Research Group and the NHS. We aim to explore the link between antibiotic use and the microbial flora in DFUs. Bacterial flora obtained via a wound swab are analysed for the presence of representative Gram positive and Gram negative bacteria, such as methicillin-resistant
Staphylococcus aureus (MRSA) and ciprofloxacin-resistant
Pseudomonas aeruginosa.
Proximal and distal factors in the rehabilitation of individuals with patellofemoral pain (PFjt)
A member of our team, Mr Craig Gwynne, is completing his PhD work on PFjt pain through three phases. The first is looking to determine a clinically appropriate method of assessing lower limb kinematics during functional activity. This will be achieved by confirming the reliability and validity of 2-dimensional measures that quantify frontal plane knee motion during single limb squats. The second phase will explore the relationship between lower limb kinematics (proximal factors) and plantar pressure (distal factors) in healthy populations and individuals with PFjt pain during functional activity via a cross-sectional study. The third phase will be a randomised clinical trial to explore the effectiveness of distal and proximal interventions in the treatment of patellofemoral pain management.
Group Members
 |  |  |
Research Lead and
Lecturer in Podiatry | Reader and Principal
Lecturer in Podiatry | Lecturer in Podiatry |
Collaborators
Internal
Professor Rose Cooper, Department of Biomedical Sciences, Cardiff School of Heath Sciences
Dr Rowena Jenkins, Department of Biomedical Sciences, Cardiff School of Heath Sciences
External
Mr Paul Williams, Department of Medical Physics, Cardiff and Vale University Health Board
Professor Neil Pugh, Department of Medical Physics, Cardiff and Vale University Health Board
Mr Michael Lewis, Department of Vascular Surgery, Royal Glamorgan Hospital
Primary Care General Practice's across Wales
Mr Scott Cawley, Podiatry Department, Cardiff and Vale University Health Board
Miss Keri Hutchinson, Podiatry Department, Cwm Taf Health Board
Mr Andrew Crowder, Diabetic Eye Screening Service Wales, Public Health Wales
Mrs Hayley-Jane Lewis, Diabetic Eye Screening Service Wales, Public Health Wales
Dr Jon Evans, Huntleigh Diagnostics
Funding
Health and Care Research Wales: "GP Ability Study" July 2015.
URGO Foundation: "A feasibility/pilot study to investigate the relationship between antibiotic use and the incidence of two representative bacteria in antibiotic resistance in diabetic foot ulcers" January 2015.
Key Publications
Arazpour M., Bani A., Hutchins SW.,
Curran SA., Sksenov A. The influence of a bespoke unloader knee brace on gait in medial compartment osteoarthritis: a pilot study.
Prosthetics and Orthotics International. 2014 Oct; 38 (5): 379-86.
Perera A., Beddard L.,
Curran S., Robertson A. Osteochondral grafting of the distal tibia without a malleolar osteomy: an all-arthroscopic antegrade approach.
Techniques in Foot and Ankle Surgery. 2015 May.
Lewis J., Lipp A. Pressure-relieving interventions for treating diabetic foot ulcers.
The Cochrane Database of Systematic Reviews. 2013 Jan; (1).
Davies JH.,
Lewis JEA., Williams EM. The utility of pulse volume waveforms in the identification of lower limb arterial insufficiency.
EWMA Journal. 2014; 14 (2).
Lewis JEA., Williams P., Davies JH. Non-invasive assessment of peripheral arterial disease: automated ankle brachial index measurement and pulse volume analysis compared to duplex scan.
SAGE Open Medicine. 2016 Jul; 4.
