老年糖尿病患者的足底压力及步态特征  

Plantar pressure and gait characteristics in older adult patients with diabetes

作　　者：卜月丽 王芳[1,2] 张建国 李晓林[1] 曹子君 李雪梅 Bu Yueli;Wang Fang;Zhang Jianguo;Li Xiaolin;Cao Zijun;Li Xuemei(College of Mechanical Engineering,Tianjin University of Science&Technology,Tianjin 300222,China;Tianjin Key Laboratory of Integrated Design and Online Monitoring for Light Industry&Food Machinery and Equipment,Tianjin 300222,China;Metabolic Disease Hospital,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]天津科技大学机械工程学院,天津市300222 [2]天津市轻工与食品工程机械装备集成设计与在线监控重点实验室,天津市300222 [3]天津医科大学代谢病医院,天津市300070

出　　处：《中国组织工程研究》2020年第5期736-740,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:研究表明,足底压力是糖尿病足溃疡的主要危险因素之一。目的:探讨老年糖尿病患者自然步态下足底压力特征及差异性,为老年患者足部的监测和足部减压产品设计提供数据支撑。方法:研究方案的实施符合天津医科大学代谢病医院对研究的相关伦理要求,所有受试者均对试验过程完全知情同意。通过鞋垫式足底压力检测系统对年龄≥60周岁的41位老年糖尿病患者和30位老年健康者自然步态下的足底压力进行检测。观察足部峰值压力、峰值时间百分比、X偏移量、Y偏移量、包络压力中心点95%椭圆置信面积、步频、步速、步幅长、站立相、摆动相。结果与结论:(1)与老年健康组相比,老年糖尿病组峰值压力集中在第2-4跖骨区显著增大,左足多数足区峰值时间百分比减小,右足足跟区、中足区峰值时间百分比增大(P <0.05);(2)与老年健康组相比,老年糖尿病组站立相降低,摆动相升高,步频降低,男性步幅长增大,步速加快,女性步幅长减小,步速减慢;(3)老年糖尿病组包络压力中心点95%椭圆置信面积较老年健康组呈减小趋势,老年糖尿病组X、Y偏移量大于老年健康组;(4)结果说明:老年糖尿病患者身体稳定性和灵活性较正常老年人降低,足底压力明显由足跟向跖骨部位转移,在足部护理中需加强对跖骨区足底压力的重视。BACKGROUND:Plantar pressure is one of the major risk factors for diabetic foot ulcers.OBJECTIVE:To explore the characteristics of plantar pressure under natural gait in older adult patients with diabetes and compare them with those in healthy older adults,providing data for preventing foot diseases and designing foot decompression products.METHODS:The study protocol was performed in accordance with the Medical Ethics Committee of Tianjin Medical University,China.Forty-one older adult patients with diabetes and 30 healthy older adults,both aged over 60 years,received plantar pressure detection using an insole-type root pressure measurement system.Peak plantar pressure,percentage of peak time,X offset,Y offset,95% confidence ellipse area,step frequency,step velocity,stride length,standing phase,and swing phase were measured.After fully understanding the study protocol,each participant provided written informed consent.RESULTS AND CONCLUSION:Compared with healthy older adults,peak plantar pressure was significantly increased in the 2nd-4thmetatarsal region,the peak time was decreased in most area of the left foot and increased in the right root heel and arch area in older adult patients with diabetes(P<0.05).Compared with healthy older adults,standing phase was decreased,swing phase was increased,step frequency was decreased,stride length in males was increased,step velocity was increased,stride length in females was decreased,and step velocity was decreased in older adult patients with diabetes.Compared with healthy older adults,95% confidence ellipse area was decreased,and X offset and Y offset were increased in older adult patients with diabetes.These results suggest that the stability and flexibility of older adult patients with diabetes are lower than those of healthy older adults.In older adult patients with diabetes,plantar pressure is obviously transferred from the heel to the humerus.Therefore,much attention should be paid to plantar pressure in foot care.

关 键 词：老年糖尿病患者 足底压力 步态 峰值压力 足部减压 

分 类 号：R446[医药卫生—诊断学] R496[医药卫生—临床医学]