Forefoot structural predictors of plantar pressures during walking in people with diabetes and peripheral neuropathy
Forefoot structural predictors of plantar pressures during walking in people with diabetes and peripheral neuropathy
复制标题
DOI：
10.1016/s0021-9290(03)00078-2
复制
发表时间：
2003-07-01
影响因子：
2.4
通讯作者：
Johnson, J
中科院分区：
文献类型：
--
作者：
Mueller, MJ;Hastings, M;Johnson, J
不同的足部结构被认为会影响步行过程中的前足足底压力。患有糖尿病（DM）和周围神经病变（PN）的人在行走过程中的高峰足底压力（PPP）可导致皮肤破裂。这项研究所解决的问题是：“在有和没有DM和PN的人群中，预测区域PPP的主要前脚结构因素是什么？”“20名患有DM和PN的人（平均年龄55+/-9岁，6名女性，14名男性，BMI = 33+/-8）和20名没有DM的人进行了测试，性别，年龄和BMI匹配。足部结构的措施，采取了从螺旋X射线计算机断层扫描构建的三维图像。步行期间记录峰值足底压力数据。分层多元回归分析被用来预测区域购买力平价在大脚趾和五个跖骨头从选定的结构和步行变量。跖趾关节角（锤状趾畸形）是预测压力的最重要变量，占糖尿病组6个位置中5个位置PPP方差的19-45%。软组织厚度、拇趾外翻和前足关节病是对照组PPP最重要的预测因素。结构变量和步行变量的组合占DM组方差的47-71%，占对照组步行期间PPP方差的52-83%。这些结构变量，特别是锤状趾畸形，应考虑在尝试制定策略，以减少过度的前足PPP，可能会导致皮肤破裂或其他伤害。(C)2003爱思唯尔科技有限公司版权所有。
Various foot structures are thought to influence forefoot plantar pressures during walking. High peak plantar pressures (PPP) during walking in people with diabetes mellitus (DM) and peripheral neuropathy (PN) can cause skin breakdown. The question addressed by this study is "What are the primary forefoot structural factors that predict regional PPP during walking in groups of people with and without DM and PN?" Twenty people with DM and PN (mean age 55+/-9 years, 6 female, 14 male, BMI = 33+/-8) and 20 people without DM, matched for gender, age, and BMI were tested. Measures of foot structure were taken from three-dimensional images constructed from spiral X-ray computed tomography. Peak plantar pressure data were recorded during walking. Hierarchical multiple regression analysis was used to predict regional PPP at the great toe and five metatarsal heads from selected structural and walking variables. Metatarsal phalangeal joint angle (hammer toe deformity) was the most important variable predicting pressure, accounting for 19-45% of the PPP variance at five of the six locations in the DM group. Soft tissue thickness, hallux valgus, and forefoot arthropathy were the most important predictors of PPP in the control group. Combinations of structural and walking variables accounted for 47-71% of the variance in the DM group and 52-83% of the variance of PPP during walking in the control group. These structural variables, especially hammer toe deformity, should be considered in attempts to develop strategies to reduce excessive forefoot PPP that may contribute to skin breakdown or other injury. (C) 2003 Elsevier Science Ltd. All rights reserved.