Biomechanics of the heel pad for type 2 diabetic patients
Biomechanics of the heel pad for type 2 diabetic patients
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DOI：
10.1016/s0268-0033(02)00018-9
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发表时间：
2002-05-01
影响因子：
1.8
通讯作者：
Shau, YW
中科院分区：
文献类型：
--
作者：
Hsu, TC;Lee, YS;Shau, YW
目标.使用数学模型量化2型糖尿病患者和年龄匹配的健康个体的足跟垫的动态行为。没有一个单一的参数可以完全描述足跟垫在加载-卸载过程中的生物力学特性。采用伪弹性模型进行描述性研究，以模拟加载和卸载状态下的鞋跟-衬垫应力-应变关系。应用透射电镜对6例糖尿病和非糖尿病患者离体小腿的足跟标本进行观察。能量耗散率，加载曲率，卸载曲率计算的应力应变曲线拟合。本文描述了糖尿病患者和健康人足跟垫超微结构的差异。糖尿病组的平均能量耗散率（平均36.1%（SD，8.7%））和平均无负荷曲率（平均11.8%（SD，5.1%）和平均8.46%（SD，2.6%））均显著高于对照组（P < 0.001）。糖尿病患者足跟部胶原纤维断裂，纤维条索不清，分布不均匀。曲率参数可以解释糖尿病患者足跟垫的回弹现象，导致高的冲击能量。胶原原纤维的断裂可能是导致这一观察结果的原因。
Objectives. To quantify the dynamic behavior of the heel pad in type 2 diabetic patients and age-matched healthy individuals using mathematical modeling.Background. No single parameter can fully describe the heel-pad biomechanical properties during the loading-unloading process.Design. A descriptive study using pseudoelastic modeling was conducted to simulate the heel-pad stress-strain relationship in the loaded and unloaded states. Transmission electron microscope was used to examine six heel specimens taken from amputated legs in diabetic and non-diabetic patients.Methods. Energy dissipation ratio, loading curvature, and unloading curvature were calculated from the stress-strain curve-fits. Differences in ultrastructure between the heel pad of healthy subjects and those with diabetes were described.Results. The diabetic patients had a significantly higher mean energy dissipation ratio (mean 36.1% (SD, 8.7%) vs mean 27.9% (SD, 6.1%); P < 0.001) and mean unloaded curvatures (mean 11.8 (SD, 5.1) vs mean 8.46 (SD, 2.6); P < 0.001) than those of the control group. The collagen fibrils in diabetic heel samples were ruptured with unclear striation and uneven distribution.Conclusions. The curvature parameters may explain the poor rebound phenomenon resulting in the high impact energy in diabetic heel pads. Breakdown in collagen fibrils may be responsible for this observation.