02571nas a2200397   4500000000100000008004100001260000900042653002900051653002000080653000900100653003100109653001500140653000900155653003100164653002100195653001100216653001200227653001200239653002400251653002200275653003900297653003200336653002300368653001200391653001000403100001300413700001600426700001100442700001500453245010100468300001000569490000600579050001500585520155900600022001402159       1995                            d  c199510aAcademies and institutes10aChronic Disease10aFoot10aFoot Deformities, Acquired10aFoot Ulcer10aHand10aHand Deformities, Acquired10aHealth Education10aHumans10aHygiene10aleprosy10aMobile Health Units10aPatient Care Team10aPeripheral Nervous System Diseases10aPhysical Therapy Modalities10aProgram evaluation10aSenegal10aShoes1 aHirzel C1 aGrauwin M Y1 aMane I1 aCartel J L00a[Results obtained by a mobile handicap-prevention unit at the Institut de Léprologie de Dakar].  a183-60 v9  aHIRZEL19953 a<p>Of 584 leprosy patients known at the Institut de Léprologie Appliquée de Dakar because they suffered a nerve lesion with or without chronic plantar ulcer (CPU), 242 (41%) could be followed-up during a mean period of time of 8.2 years (range: 5 and 10 years) by the means of the mobile disability prevention team (health education, medical care and shoe workshop). Every two months a visit of the patients, at their home town, was organized, with the purpose to assess whether they could actually put into practice the foot and hand as having been trained for. At the same time, further advice and encouragement were given to the patients. Adapted footwear was brought to the patient, at reduced fee, the foot prints and special moulds having been taken during the previous visit. The local health worker were responsible for light surgical cares. Among the 242 followed-up patients: of 107 without CPU at beginning, 90 (84%) remained so, of 135 with CPU at beginning, 57 (42%) were cured, of 135 with CPU at beginning, 74 (55%) remained stable (no worsening), the last 21, of whom 17 showed severe foot deformities but without CPU, worsened (all presented one or more CPU at the last control). Of the 242 patients, 221 (91%) remained stable or showed substantial improvement. Therefore, it must be emphasized that careful follow-up of patients is essential to insure the improvement or care of CPU as well as to prevent the onset, worsening or reappearance of CPU. Such follow-up must consist of cares, health education and special shoe wearing.</p>  a0001-5938