[1]王俊思,白姣姣,孙皎,等.基于足形与足底压力的老年糖尿病危险足护足鞋具的设计与应用研究[J].军事护理,2023,40(02):28-32.[doi:10.3969/j.issn.2097-1826.2023.02.007]
　WANG Junsi,BAI Jiaojiao,SUN Jiao,et al.Design and Application Evaluation of Foot Protective Shoes for Elderly Patients with Diabetic Foot Risk Based on Foot Shape and Plantar Pressure[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(02):28-32.[doi:10.3969/j.issn.2097-1826.2023.02.007]
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基于足形与足底压力的老年糖尿病危险足护足鞋具的设计与应用研究
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《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
40
期数:
2023年02期
页码:
28-32
栏目:
论著
出版日期:
2023-02-15

文章信息/Info

Title:
Design and Application Evaluation of Foot Protective Shoes for Elderly Patients with Diabetic Foot Risk Based on Foot Shape and Plantar Pressure
文章编号:
2097-1826(2023)02-0028-05
作者:
王俊思; 白姣姣; 孙皎; 王峥; 宋品芳; 房晨斐; 周琳; 石磊
(复旦大学附属华东医院 糖尿病足整合门诊,上海 200040)
Author(s):
WANG Junsi; BAI Jiaojiao; SUN Jiao; WANG Zheng; SONG Pinfang; FANG Chenfei; ZHOU Lin; SHI Lei
(Diabetic Foot Integration Clinic,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,China)
关键词:
老年糖尿病;  危险足;  护足鞋具;  足形;  足底压力
Keywords:
elder diabetes;  risk foot;  protective shoes;  foot;  plantar pressure
分类号:
R473.58
DOI:
10.3969/j.issn.2097-1826.2023.02.007
文献标志码:
A
摘要:
目的 设计基于足形与足底压力的老年糖尿病危险足护足鞋具,并评价其应用效果,以期为预防足溃疡的发生提供有效护具。方法 通过文献回顾、研究团队的前期研究、专家意见以及预实验确定鞋具的设计方案。在上海市长宁区某社区卫生服务中心招募老年糖尿病危险足患者96例,按随机数字表法分为对照组和观察组。对照组穿着根据鞋码统一制作的老人鞋,观察组穿着依据护足鞋具设计方案制作的鞋具,干预3个月。干预前后评估两组患者赤足及穿鞋状态下的足底峰值压力、冲量以及足底压力中心轨迹(center of pressure,COP)曲线等指标。结果 干预后,观察组患者赤足及穿鞋状态下的足底峰值压力均低于对照组(均P<0.05); 赤足状态下左、右足的最大冲量、总冲量均低于对照组(均P<0.05); COP曲线异常比例低于对照组(P<0.05),差异均有统计学意义。结论 基于足形与足底压力设计的老年糖尿病危险足护足鞋具,能有效降低患者的足底峰值压力、冲量及改善足底压力中心轨迹,对预防足溃疡具有积极意义。
Abstract:
Objective To design and evaluate the foot protective shoes for elderly patients with diabetic foot risk based on foot shape and plantar pressure,and to provide effective protective footwear for preventing foot ulcers.Methods Through literature review,preliminary research,expert opinions and pre-experiment,the design scheme of footwear for elderly patients with diabetic foot risk was constructed.96 elderly patients with diabetic foot risk were recruited to evaluate the application effect of footwear from a community service center in Changning District,Shanghai,and the patients were divided into control group and observation group according to random number table.The control group wore shoes made according to shoe size,and the observation group wore the shoes made according to the design scheme of foot protective shoes.The intervention time was 3 months.Plantar peak pressure,impulse and center of pressure(COP)trajectory were evaluated before and after the intervention.Results After intervention,the plantar peak pressure of the observation group was lower than that of the control group in barefoot and in shoes(all P< 0.05).The maximum impulse and total impulse of the left and right foot in the bare condition in the observation group were lower than those in the control group(all P<0.05).The abnormal ratio of the COP trajectory of the observation group was lower than that of the control group(P<0.05).Conclusions The protective shoes designed based on foot shape and plantar pressure for elderly patients with diabetic foot risk can effectively reduce the patients' plantar peak pressure,impulse and improve the COP trajectory,which is of positive significance for the prevention of foot ulcers.

参考文献/References:

[1] 《中国老年型糖尿病防治临床指南》编写组.中国老年2型糖尿病防治临床指南(2022年版)[J].中国糖尿病杂志,2022,30(1):2-51.
[2] 中华医学会糖尿病学分会,中华医学会感染病学分会,中华医学会组织修复与再生分会.中国糖尿病足防治指南(2019版)(Ⅰ)[J].中华糖尿病杂志,2019,11(2):92-108.
[3] BUS S A,LAVERY L A,MONTEIRO-SOARES M,et al.Guidelines on the prevention of foot ulcers in persons with diabetes(IWGDF 2019 update)[J/OL].[2022-05-30].https://onlinelibrary.wiley.com/doi/10.1002/dmrr.3269.DOI:10.1002/dmrr.3269.
[4] 王俊思,白姣姣.糖尿病危险足患者减压鞋具干预的研究进展[J].护理学杂志,2020,35(24):102-105.
[5] ALBERTI K G,ZIMMET P Z.Definition,diagnosis and classification of diabetes mellitus and its complications.Part 1:diagnosis and classification of diabetes mellitus provisional report of a WHO consultation[J].Diabet Med,1998,15(7):539-553.
[6] WAGNER F J.The dysvascular foot:a system for diagnosis and treatment[J].Foot Ankle,1981,2(2):64-122.
[7] VAN NETTEN J J,LAZZARINI P A,ARMSTRONG D G,et al.Diabetic foot Australia guideline on footwear for people with diabetes[J/OL].[2022-05-30].https://jfootankleres.biomedcentral.com/articles/10.1186/s13047-017-0244-z.DOI:10.1186/s13047-017-0244-z.
[8] 中华医学会糖尿病学分会,中华医学会感染病学分会,中华医学会组织修复与再生分会.中国糖尿病足防治指南(2019版)(Ⅰ)[J].中华糖尿病杂志,2019,11(2):92-108.
[9] 白姣姣,孙皎.老年糖尿病甲病处理技术[M].上海:上海科学技术出版社,2018:90-94.
[10]WAAIJMAN R,BUS S A.The interdependency of peak pressure and pressure-time integral in pressure studies on diabetic footwear:no need to report both parameters[J].Gait Posture,2012,35(1):1-5.
[11]ZWAFERINK J,CUSTERS W,PAARDEKOOPER I,et al.Optimizing footwear for the diabetic foot:data-driven custom-made footwear concepts and their effect on pressure relief to prevent diabetic foot ulceration[J/OL].[2022-05-30].https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224010.DOI:10.1371/journal.pone.0224010.
[12]TELFER S,WOODBURN J,COLLIER A,et al.Virtually optimized insoles for offloading the diabetic foot:a randomized crossover study[J].J Biomech,2017(60):157-161.
[13]SCHAPER N C,VAN NETTEN J J,APELQVIST J,et al.Practical guidelines on the prevention and management of diabetic foot disease(IWGDF 2019 update)[J/OL].[2022-05-30].https://onlinelibrary.wiley.com/doi/10.1002/dmrr.3266.DOI:10.1002/dmrr.3266.
[14]ARTS M L J,DE HAART M,BUS S A,et al.Perceived usability and use of custom-made footwear in diabetic patients at high risk for foot ulceration[J].J Rehabil Med,2014,46(4):357-362.
[15]PATON J S,STENHOUSE E A,BRUCE G,et al.A comparison of customised and prefabricated insoles to reduce risk factors for neuropathic diabetic foot ulceration:a participant-blinded randomised controlled trial[J/OL].[2022-05-30].https://jfootankleres.biomedcentral.com/articles/10.1186/1757-1146-5-31.DOI:10.1186/1757-1146-5-31.
[16]TANG L,WANG L,BAO W,et al.Functional gradient structural design of customized diabetic insoles[J].J Mech Behav Biomed Mater,2019(94):279-287.
[17]HORSTINK K A,VAN DER WOUDE L,Hijmans J M.Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy:a systematic review[J].Rev Endocr Metab Disord,2021,22(2):325-335.

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备注/Memo

备注/Memo:
【 收稿日期 】 2022-06-22 【 修回日期 】 2022-12-08
【 基金项目 】 上海市卫生健康委项目(2019SY007)
【 作者简介 】 王俊思,硕士,电话:021-62483180
【 通信作者 】 白姣姣,电话:021-62483180-720232
更新日期/Last Update: 2023-02-15