特殊糖尿病鞋对糖尿病患者行走时足底压力分布的影响

发布时间：2018-04-26 22:38

本文选题：糖尿病鞋 + 神经病变　；参考：《北京体育大学》2014年硕士论文

【摘要】：研究目的：糖尿病患者异常的足底压力分布会造成足底溃疡的风险,而合适的鞋对糖尿病患者的足部能起到改善足底压力分布,降低溃疡风险的作用。本研究通过对比糖尿病患者穿着一种糖尿病鞋和普通鞋时的动态足底压力变化,分析该糖尿病鞋对于糖尿病患者足底压力分布的影响。研究方法：参与实验的受试者均为男性,其中糖尿病神经病变组(病变组)11名,糖尿病无神经病变组(病控组)13名,健康对照组(对照组)15名。首先使用footscan足底压力平板测试3组受试者赤足行走行走时的足底压力,了解有神经病变的糖尿病患者和无神经病变的糖尿病患者的足底压力分布特征。然后让糖尿病神经病变患者和糖尿病无神经病变患者分别穿普通鞋和糖尿病鞋进行鞋内压测试和鞋外压测试。鞋内压测试使用Novel-Pedar鞋垫式压力测试系统,鞋外压测试使用footscan足底压力平板。两种鞋的测试顺序随机。运用SPSS软件中的独立样本t检验检验赤足行走测试的数据,运用重复测量方差分析检验穿鞋测试的数据,统计结果的显著性水平为P0.05。研究结果：赤足行走时,病变组与病控组趾骨区中部的标准化峰值压强显著低于对照组；病变组和对照组赤足行走时全足平衡曲线在y轴上的峰值显著更大。无论穿普通鞋还是穿糖尿病鞋,病变组在趾骨区的标准压强时间积分都显著大于病控组；而穿糖尿病鞋的两组受试者在足中部的标准化峰值压力和标准化压力时间积分都显著大于穿普通鞋时。研究结论：(1)赤足行走状态下糖尿病神经病变患者趾骨区中部的标准化峰值压强显著低于健康对照组。与健康对照组相比,糖尿病神经病变患者和糖尿病非神经病变患者赤足行走时在蹬离地阶段更倾向内侧用力。 (2)糖尿病神经病变患者在趾骨区的压强时间积分显著大于糖尿病非神经病变患者。糖尿病神经病变患者足中部着地时间显著比糖尿病非神经病变患者短。 (3)糖尿病神经病变患者跖骨区的鞋内压标准化压强时间积分显著高于糖尿病无神经病变患者。两组受试者穿糖尿病鞋时足中部峰值压力和压力时间积分都大于穿普通鞋时,而跖骨区和后跟区的冲量与穿普通鞋时无显著差异。
[Abstract]:Objective: abnormal plantar pressure distribution in diabetic patients may result in the risk of plantar ulcers, and proper shoes can improve the foot pressure distribution and reduce the risk of ulceration in diabetic patients. In this study, the effect of diabetic shoes on foot pressure distribution in diabetic patients was analyzed by comparing the dynamic sole pressure changes between a diabetic shoe and a common shoe. Methods: all the subjects were male, including 11 diabetic neuropathy group, 13 diabetic non-neuropathy group and 15 healthy control group. First, the plantar pressure of three groups of subjects walking barefoot was measured with footscan plantar pressure plate to understand the characteristics of foot pressure distribution in diabetic patients with neuropathy and diabetic patients without neuropathy. Then the patients with diabetic neuropathy and the patients without diabetic neuropathy were asked to wear common shoes and diabetic shoes to test the internal pressure of shoes and the external pressure of shoes respectively. Novel-Pedar insole pressure test system was used in shoe inner pressure test and footscan sole pressure plate was used for shoe external pressure test. The test sequence of two kinds of shoes is random. The data of barefoot walking test was tested by independent sample t-test in SPSS software, and the data of shoe wear test was tested by repeated measurement variance analysis. The significant level of the statistical result was P0.05. Results: the standardized peak pressure in the middle of phalanx was significantly lower in the lesion group and the disease control group than in the control group, and the peak value of the balance curve of the whole foot in the y axis was significantly larger in the lesion group and the control group. Whether wearing common shoes or wearing diabetic shoes, the standard pressure time integral in the phalangeal area in the lesion group was significantly higher than that in the disease control group. The standardized peak pressure and standardized pressure time score in the middle of the foot were significantly higher in the diabetic shoes group than in the normal shoes group. Conclusion the standardized peak pressure in the middle of the phalanx was significantly lower in the patients with diabetic neuropathy under barefoot walking than that in the healthy control group. Compared with the healthy control group, diabetic neuropathy patients and diabetic non-neuropathy patients were more inclined to the medial force when walking barefoot. 2) the pressure time integral of diabetic neuropathy patients was significantly higher than that of diabetic non-neuropathy patients. The time of landing in the middle of the foot in diabetic neuropathy patients was significantly shorter than that in non-diabetic neuropathy patients. 3) the time integral of standardized pressure in the metatarsal area of patients with diabetic neuropathy was significantly higher than that in patients without diabetic neuropathy. The peak pressure and pressure time score in the middle part of the foot were higher than those in the normal shoe, but the impulse in the metatarsal area and heel area had no significant difference between the two groups.
【学位授予单位】：北京体育大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R587.2;R318.01

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