Temporal characteristics of plantar shear distribution: relevance to diabetic patients.
Temporal characteristics of plantar shear distribution: relevance to diabetic patients.
复制标题
足底剪切力分布的时间特征：与糖尿病患者的相关性。
DOI：
10.1016/j.jbiomech.2007.10.008
复制
发表时间：
2008
影响因子：
2.4
通讯作者：
Davis,BrianL
中科院分区：
文献类型：
--
作者：
Yavuz,Metin;Tajaddini,Azita;Botek,Georgeanne;Davis,BrianL
糖尿病足溃疡是已知的生物力学病因。在导致足部损伤的力学因素中，剪切力要么被忽视，要么被低估。这项研究的目的是确定糖尿病组和对照组的各种足底压力和切变变量，并对它们进行比较。糖尿病伴神经病变患者15例，无足部症状的非糖尿病患者20例。受试者走在一个定制的平台上，能够同时测量局部的法向力和切向力。糖尿病组压力-时间积分量增加54%(p=0.013)。研究发现，即使糖尿病患者的步行速度较慢，AP峰值和由此产生的剪切值也增加了约32%(p<；0.05)。对照组的AP和ML应力范围(峰峰值)较低(p<；0.05)。糖尿病组的切变时间积分值在AP和合并切变病例中分别增加了61%和132%(p<；0.05)。已知足底剪切是骨痂形成的一个因素，以前曾与较高的溃疡发生率有关。在步态过程中，剪应力以两倍于压力的频率产生。因此，应从更广泛的角度进一步研究足底剪切，包括受影响足底组织的时间规格和疲劳破坏特征。
Diabetic foot ulcers are known to have a biomechanical etiology. Among the mechanical factors that cause foot lesions, shear stresses have been either neglected or underestimated. The purpose of this study was to determine various plantar pressure and shear variables in the diabetic and control groups and compare them. Fifteen diabetic patients with neuropathy and 20 non-diabetic subjects without foot symptoms were recruited. Subjects walked on a custom-built platform capable of measuring local normal and tangential forces simultaneously. Pressure-time integral quantities were increased by 54% (p=0.013) in the diabetic group. Peak AP and resultant shear magnitudes were found to be about 32% larger (p<0.05), even though diabetic subjects walked at a slower velocity. Lower AP and ML stress range (peak-to-peak) values were observed in the control subjects (p<0.05). Shear-time integral values were increased in the diabetic group by 61% and 132% for AP and resultant shear cases, respectively (p<0.05). Plantar shear is known to be a factor in callus formation and has previously been associated with higher ulcer incidence. During gait, shear stresses are induced with twice the frequency of pressure characteristically. Therefore, plantar shear should be investigated further from a broader perspective including the temporal specifications and fatigue failure characteristics of the affected plantar tissue.