Novel Rocker Shoes for Offloading Diabetic Feet

 描述(申请人提供)：糖尿病相关足部溃疡很常见，随着糖尿病患病率的增加，其患病率可能会增加。在美国，糖尿病足部溃疡的治疗费用估计每年超过100亿美元(Gordois 2003)。已经证实，每年约60-70,000例(CDC)与糖尿病相关的下肢截肢中的大多数在足部溃疡之前(Pecoraro等人)。1990年)。由于足底神经性足部溃疡与足底高压力有关，足底机械卸载是成功预防的关键。硬质摇杆和滚轴鞋已被证明是最成功的鞋类干预措施之一，以减少足底压力下的跖头。然而，目前摇臂鞋设计的某些方面(例如，鞋的高度、重量和外观)阻碍了在糖尿病神经病变患者中更广泛的使用。在这项研究中，我们建议开发新型的患者专用摇臂和滚筒鞋，其中通过鞋的外部和内部的表面几何形状来促进卸载。由此产生的鞋子将不会有以前摇滚鞋典型的极端外角，再加上基于足底压力分布的个性化，它应该可以克服上述传统摇摆鞋的前三个缺点。先前没有研究专门尝试解决可能增强拇指减负的修改。我们提出了以下具体目标：具体目标#1：设计和测试两层结构的摇杆和滚轴鞋-其中一层在鞋内。具体目标#2：基于足底压力分布，将摇臂/滚轮顶端放置、内部摇臂放置和鞋垫设计融为一体。具体目标3：研究卸除拇指的各种选择。

 DESCRIPTION (provided by applicant): Diabetes related foot ulcers are common and their prevalence is likely to increase as the prevalence of diabetes increases. The cost of treating of diabetic foot ulcers is estimated at over $10 billion annually in the US (Gordois 2003). It has als been established that the majority of the ~60-70,000 (CDC) annual diabetes related lower extremity amputations are preceded by a foot ulcer (Pecoraro et al. 1990). Since plantar neuropathic foot ulcers are related to high plantar pressure, plantar mechanical offloading is essential to successful prevention. Rigid rocker and roller shoes have been shown to be one of the most successful footwear interventions for the reduction of plantar pressure under the metatarsal heads. However, certain aspects of current rocker shoe designs (e.g., shoe height, weight and appearance) have prevented more widespread use in diabetic neuropathic patients. In this study, we propose to develop novel patient-specific rocker and roller shoes in which the offloading is facilitated by surface geometry that is both external and internal to the shoe. The resulting shoe will not have the extreme external angle typical of previous rockers and, together with personalization based on plantar pressure distribution, it should overcome the first three of the drawbacks of traditional rocker shoes mentioned above. No prior research has specifically attempted to address modifications that may enhance hallux offloading. We propose the following specific aims: Specific Aim #1: To design and test rocker and roller shoes with a two-layer construction - where one of the layers is inside the shoe. Specific Aim #2: To incorporate rocker/roller apex placement, internal rocker placement, and insole design based on plantar pressure distribution. Specific Aim #3: To examine options for offloading the hallux.