Novel Rocker Shoes for Offloading Diabetic Feet

 描述（由申请人提供）： 糖尿病相关的足部溃疡很常见，随着糖尿病患病率的增加，其患病率可能会增加。在美国，治疗糖尿病足溃疡的费用估计每年超过100亿美元（Gordois 2003）。还确定每年约60- 70，000例（CDC）糖尿病相关下肢截肢中的大多数发生在足部溃疡之前（Pecoraro等人，1990）。由于足底神经性足部溃疡与足底高压有关，足底机械卸载对于成功预防至关重要。刚性摇杆和滚轴鞋已被证明是最成功的鞋类干预措施之一，以减少跖骨头下的足底压力。然而，当前摇鞋设计的某些方面（例如，鞋的高度、重量和外观）已经阻止了在糖尿病神经病患者中更广泛的使用。在这项研究中，我们建议开发新的患者特定的摇杆和滚轴鞋，其中的卸载是由表面几何形状，这是外部和内部的鞋。所得到的鞋将不具有先前摇杆鞋典型的极端外部角度，并且与基于足底压力分布的个性化一起，它应该克服上述传统摇杆鞋的前三个缺点。没有先前的研究专门试图解决可能增加拇趾卸载的修改。我们提出了以下具体目标：具体目标#1：设计和测试双层结构的摇杆和滚轴鞋-其中一层在鞋内。具体目标#2：根据足底压力分布，结合摇杆/滚轮顶点放置、内部摇杆放置和鞋垫设计。具体目标#3：检查减轻拇趾的选择。

 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.