Relationships between segmental foot mobility and plantar loading in individuals with and without diabetes and neuropathy.
Relationships between segmental foot mobility and plantar loading in individuals with and without diabetes and neuropathy.
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DOI：
10.1016/j.gaitpost.2009.10.016
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发表时间：
2010-02
期刊：
影响因子：
2.4
通讯作者：
Yack, H. John
中科院分区：
文献类型：
--
作者：
Rao, Smita;Saltzman, Charles L.;Yack, H. John
我们的研究目的是检查动态足部功能在步态中，因为它涉及足底负荷的个人与糖尿病（糖尿病和神经病变）相比，匹配的对照组。使用多节段运动学模型检查步态期间的足部活动性，并使用足压计测量DM受试者（N=15）和对照受试者（N=15）的足底负荷。皮尔逊积差相关用于评估感兴趣的变量之间的关系。使用基于Fisher Z变换（α=0.05）的近似检验评估相关性的统计学显著性和等同性。在糖尿病患者中，步态期间第一跖骨矢状面偏移与内侧前足下的压力时间积分呈负相关（r =-0.42和-0.06，DM和Ctrl，P= 0.02）。同样，步态期间的外侧前足矢状面偏移与外侧前足下的压力时间积分呈负相关（r =-0.56和-0.11，DM和Ctrl，P = 0.02）。跟骨的额面偏移与内侧（r=-0.57和0.12，DM和Ctrl，P < 0.01）和外侧（r=-0.51和0.13，DM和Ctrl，P < 0.01）足跟和内侧前足压力时间积分（r=-0.56和0.02，DM和Ctrl，P < 0.01）呈负相关。我们研究的主要发现表明，糖尿病患者节段性足活动度的降低伴随着局部负荷的增加。行走过程中额面跟骨活动度的降低是DM患者足部灵活性丧失的重要功能标志。
The purpose of our study was to examine dynamic foot function during gait as it relates to plantar loading in individuals with DM (diabetes mellitus and neuropathy) compared to matched control subjects. Foot mobility during gait was examined using a multi-segment kinematic model, and plantar loading was measured using a pedobarograph in subjects with DM (N=15), control subjects (N=15). Pearson product moment correlation was used to assess the relationship between variables of interest. Statistical significance and equality of correlations were assessed using approximate tests based on Fisher’s Z transformation (α=0.05). In individuals with DM, 1st metatarsal sagittal plane excursion during gait was negatively associated with pressure time integral under the medial forefoot (r = −0.42 and −0.06, DM and Ctrl, P= 0.02). Similarly, lateral forefoot sagittal plane excursion during gait was negatively associated with pressure time integral under the lateral forefoot (r = −0.56 and −0.11, DM and Ctrl, P = 0.02). Frontal plane excursion of the calcaneus was negatively associated with medial (r= −0.57 and 0.12, DM and Ctrl, P < 0.01) and lateral (r= −0.51 and 0.13, DM and Ctrl, P < 0.01) heel and medial forefoot pressure time integral (r= −0.56 and −0.02, DM and Ctrl, P < 0.01). The key findings of our study indicate that reductions in segmental foot mobility were accompanied by increases in local loading in subjects with DM. Reduction in frontal plane calcaneal mobility during walking serves as an important functional marker of loss of foot flexibility in subjects with DM.
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