Clustering and classification of regional peak plantar pressures of diabetic feet.
Clustering and classification of regional peak plantar pressures of diabetic feet.
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DOI：
10.1016/j.jbiomech.2012.09.007
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发表时间：
2013-01-04
影响因子：
2.4
通讯作者：
Cavanagh PR
中科院分区：
文献类型：
--
作者：
Bennetts CJ;Owings TM;Erdemir A;Botek G;Cavanagh PR
高足底压力与糖尿病患者的足部溃疡有关，糖尿病患者可能会因周围神经病变而失去保护性感觉。因此，升高的足底压力分布的表征可以提供识别处于足部溃疡的潜在风险的糖尿病患者的手段。足底压力分布分类也可用于确定合适的预防性干预，例如提供适当设计的鞋垫。在过去，重点主要放在确定个别重点高压领域。本研究的目的是利用k均值聚类分析，以确定典型的区域峰值足底压力分布在一组819糖尿病足。集群的数量从2到10不等，以检查对区域峰值足底压力分布的分化和分类的影响。随着组数的增加，其压力分布的特异性也增加：从总体低或总体高峰压力组开始，并扩展到在足部不同区域显示几个焦点峰值压力的集群。然而，随着聚类数目的增加，对给定区域峰值足底压力分布进行准确分类的能力降低。当评估足部有潜在“风险”的患者或处方鞋类以减少高区域压力时，可以调整这些相反约束之间的平衡。该分析提供了对糖尿病人群中所见的区域峰值足底压力分布的变异性的理解，并作为糖尿病足溃疡的抢先评估和预防的指南。
High plantar pressures have been associated with foot ulceration in people with diabetes, who can experience loss of protective sensation due to peripheral neuropathy. Therefore, characterization of elevated plantar pressure distributions can provide a means of identifying diabetic patients at potential risk of foot ulceration. Plantar pressure distribution classification can also be used to determine suitable preventive interventions, such as the provision of an appropriately designed insole. In the past, emphasis has primarily been placed on the identification of individual focal areas of elevated pressure. The goal of this study was to utilize k-means clustering analysis to identify typical regional peak plantar pressure distributions in a group of 819 diabetic feet. The number of clusters was varied from 2 to 10 to examine the effect on the differentiation and classification of regional peak plantar pressure distributions. As the number of groups increased, so too did the specificity of their pressure distributions: starting with overall low or overall high peak pressure groups and extending to clusters exhibiting several focal peak pressures in different regions of the foot. However, as the number of clusters increased, the ability to accurately classify a given regional peak plantar pressure distribution decreased. The balance between these opposing constraints can be adjusted when assessing patients with feet that are potentially “at risk” or while prescribing footwear to reduce high regional pressures. This analysis provides an understanding of the variability of the regional peak plantar pressure distributions seen within the diabetic population and serves as a guide for the preemptive assessment and prevention of diabetic foot ulcers.