Effect of peak pressure and pressure gradient on subsurface shear stresses in the neuropathic foot.
Effect of peak pressure and pressure gradient on subsurface shear stresses in the neuropathic foot.
复制标题
峰值压力和压力梯度对神经性足部表面下剪切应力的影响。
DOI：
10.1016/j.jbiomech.2006.03.005
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发表时间：
2007
影响因子：
2.4
通讯作者：
Lott,DonovanJ
中科院分区：
文献类型：
--
作者：
Zou,Dequan;Mueller,MichaelJ;Lott,DonovanJ
足底表面的压力分布可以为糖尿病和周围神经病变(PN)患者的皮下组织内应力提供深入的了解，这些患者有皮肤破裂的风险。本研究的目的是(1)根据测量的表面压力分布估计软组织中的应力分布，并确定前足和后足的值之间的差异，以及(2)确定最大剪应力(MSS)(大小和深度)与压力分布特征之间的关系。以足底压力峰值和足底最大压力梯度为特征，对20例糖尿病、PN和足中、前足底溃疡患者在步行过程中测得的足底压力分布进行了分析。用势函数法研究了峰值压力和峰值压力处的最大压力梯度对软组织应力分量的影响。与后足相比，计算出的MSSS的大小更大，并且更接近前脚的表面，那里是大多数皮肤破裂发生的地方。此外，MSS(震级和深度)与压力梯度(r=-0.77和0.61)和峰值压力(r=-0.61和0.91)高度相关。从表面压力分布得到的峰值压力和最大压力梯度似乎是识别MSSS在足底皮下组织中的位置的重要变量，可能导致皮肤破裂。
The pressure distribution on the plantar surface of the foot may provide insights into the stresses within the subsurface tissues of patients with diabetes mellitus and peripheral neuropathy (PN) who are at risk for skin breakdown. The purposes of this study were to (1) estimate the stress distribution in the subsurface soft tissue from a measured surface pressure distribution and determine any differences between values in the forefoot and rearfoot, and (2) determine the relationship between maximum shear stress (MSS) (magnitude and depth) and characteristics of the pressure distribution. The measured in-shoe pressure distributions during walking characterized by the peak plantar pressure and maximum pressure gradient on the plantar surface of the feet for 20 subjects with diabetes, PN and history of a mid foot or forefoot plantar ulcer were analyzed. The effects of peak pressure and maximum pressure gradient at the peak pressure location on the stress components in the subsurface soft tissue were studied using a potential function method to estimate the subsurface tissue stress. The calculated MSSs are larger in magnitude and located closer to the surface in the forefoot, where most skin breakdown occurs, compared to the rearfoot. In addition, the MSS (magnitude and depth) is highly correlated with the pressure gradient (r=-0.77 & 0.61) and the peak pressure (r=-0.61 & 0.91). The peak pressure and the maximum pressure gradient obtained from the surface pressure distribution appear to be important variables to identify where MSSs are located in the subsurface tissues on the plantar foot that may lead to skin break down.
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