Edorium journal of disability and rehabilitation最新文献

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Impact of foot progression angle modification on plantar loading in individuals with diabetes mellitus and peripheral neuropathy 糖尿病和周围神经病变患者足部进展角度改变对足底负荷的影响

Edorium journal of disability and rehabilitation

Pub Date : 2016-03-11 DOI: 10.5348/D05-2016-7-OA-3

E. Merriwether, M. Hastings, Kathryn L. Bohnert, J. Hollman, M. Strube, D. Sinacore

Aims To determine if participants can reduce foot progression angle (FPA), and if FPA reduction decreases regional plantar stresses and forces in individuals with diabetes. Methods Design Three-group cross-sectional design with repeated measures. subjects twenty-eight participants either with diabetes mellitus (DM), diabetes and peripheral neuropathy with (DMPN+NPU) or without a prior history of ulceration (DMPN−NPU) were studied. Intervention Participants were first instructed to walk over a 3.6 m walkway at their preferred FPA, and then to walk with their foot aligned parallel with the line of gait progression at their self-selected speed. Dynamic plantar kinetics in six masked regions were collected using an EMED-st-P-2 pedobarograph. Main measures Primary outcome measures were FPA, peak plantar pressure (PPP), and force-time integral (FTI). A repeated measures ANOVA was conducted to determine group differences in FPA for both walking conditions. Regional differences in PPPs and FTIs between preferred and corrected walking conditions were analyzed using repeated measures ANCOVA. Results Participants showed a reduction in FPA magnitude on the ‘Involved’ foot between the preferred and corrected walking conditions (p<0.01). There were no differences in PPPs or FTIs in any mask between walking conditions (p>0.05). Conclusion Results from this investigation offer important evidence that people with diabetes can modify their FPA with a simple intervention of visual and verbal cueing. Future research should examine if gait retraining strategies in regular footwear more effectively offload areas of elevated regional plantar stresses and forces in adults with diabetes mellitus and peripheral neuropathy.

目的确定参与者是否可以降低足部进展角(FPA)，以及FPA的减少是否可以降低糖尿病患者的足底压力和受力。方法设计三组横断面设计，重复测量。研究对象28名患有糖尿病(DM)、糖尿病和周围神经病变(DMPN+NPU)或无溃疡史(DMPN - NPU)的参与者。参与者首先被指示以他们喜欢的FPA在3.6米的人行道上行走，然后以他们自己选择的速度使他们的脚与步态进展线平行。使用EMED-st-P-2足压仪收集了六个掩蔽区的动态足底动力学。主要观察指标为FPA、足底峰值压力(PPP)和力-时间积分(FTI)。采用重复测量方差分析来确定两种行走条件下FPA的组间差异。使用重复测量ANCOVA分析首选和矫正步行条件之间ppp和fti的区域差异。结果:在首选步行条件和矫正步行条件之间，参与者显示“受累”足的FPA大小减少(p0.05)。结论本研究结果为糖尿病患者可以通过简单的视觉和语言提示干预来改变他们的FPA提供了重要的证据。未来的研究应该检查步态再训练策略是否能更有效地减轻患有糖尿病和周围神经病变的成人足底应力和力量升高的区域。

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引用次数: 10

Impact of foot progression angle modification on plantar loading in individuals with diabetes mellitus and peripheral neuropathy. 修改足底进步角对糖尿病和周围神经病变患者足底负荷的影响。

Edorium journal of disability and rehabilitation

Pub Date : 2016-01-01 Epub Date: 2016-03-26

Ericka N Merriwether, Mary K Hastings, Kathryn L Bohnert, John H Hollman, Michael J Strube, David R Sinacore

Aims: To determine if participants can reduce foot progression angle (FPA), and if FPA reduction decreases regional plantar stresses and forces in individuals with diabetes.

Methods: Design: Three-group cross-sectional design with repeated measures. subjects: twenty-eight participants either with diabetes mellitus (DM), diabetes and peripheral neuropathy with (DMPN+NPU) or without a prior history of ulceration (DMPN-NPU) were studied. Intervention: Participants were first instructed to walk over a 3.6 m walkway at their preferred FPA, and then to walk with their foot aligned parallel with the line of gait progression at their self-selected speed. Dynamic plantar kinetics in six masked regions were collected using an EMED-st-P-2 pedobarograph. Main measures: Primary outcome measures were FPA, peak plantar pressure (PPP), and force-time integral (FTI). A repeated measures ANOVA was conducted to determine group differences in FPA for both walking conditions. Regional differences in PPPs and FTIs between preferred and corrected walking conditions were analyzed using repeated measures ANCOVA.

Results: Participants showed a reduction in FPA magnitude on the 'Involved' foot between the preferred and corrected walking conditions (p<0.01). There were no differences in PPPs or FTIs in any mask between walking conditions (p>0.05).

Conclusion: Results from this investigation offer important evidence that people with diabetes can modify their FPA with a simple intervention of visual and verbal cueing. Future research should examine if gait retraining strategies in regular footwear more effectively offload areas of elevated regional plantar stresses and forces in adults with diabetes mellitus and peripheral neuropathy.

目的：确定参与者是否能减小足底进步角（FPA），以及减小FPA是否能降低糖尿病患者的区域性足底应力和压力：设计：受试者：28 名糖尿病（DM）、糖尿病和周围神经病变患者（DMPN+NPU）或无溃疡病史者（DMPN-NPU）。干预：首先指导受试者以自己喜欢的 FPA 走过 3.6 米长的人行道，然后让他们的脚与步态行进线平行，以自己选择的速度行走。使用 EMED-st-P-2 足动仪收集六个遮蔽区域的动态足底动力。主要测量指标：主要结果指标为 FPA、足底压力峰值 (PPP) 和力-时间积分 (FTI)。采用重复测量方差分析确定两种行走条件下 FPA 的组间差异。使用重复测量方差分析了首选步行条件和矫正步行条件下 PPP 和 FTI 的区域差异：结果：在首选步行条件和修正步行条件之间，参与者 "受累 "脚的 FPA 幅值有所降低（pp>0.05）：这项调查的结果提供了重要的证据，证明糖尿病患者可以通过简单的视觉和语言提示干预来改变他们的 FPA。未来的研究应考察穿着普通鞋的步态再训练策略是否能更有效地卸载糖尿病和周围神经病变成人足底应力和力量升高的区域。

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引用次数: 0

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