Lobmann R, Kayser R, Kasten G, Kasten U, Kluge K, Neumann W, Lehnert H
Department of Endocrinology and Metabolism, University Medical School of Magdeburg, Germany.
Diabet Med. 2001 Apr;18(4):314-9. doi: 10.1046/j.1464-5491.2001.00482.x.
This study analysed the effects of specially manufactured insoles on foot pressures in diabetic patients during a 1-year prospective observation period.
We studied 81 type 2 diabetic patients without foot lesions. Using pedobarography three different regions of interest were examined: maximum peak pressure (MPP) of the total foot area, heel region and head of metatarsal bone I-III. Eighteen patients with high risk pressure (MPP of total foot 474 +/- 183 kPa; heel region 278 +/- 147 kPa, metatarsal 389 +/- 222 kPa) received optimal insole support. Sixty-three patients as a control group (MMP of total foot 367.7 +/- 157 kPa; heel 263.1 +/- 127 kPa, metatarsal 339.9 +/- 171 kPa) received conventional footwear.
After insole support a 30% pressure reduction of total foot MMP (474 +/- 183 kPa vs. 290 +/- 106 kPa) was achieved in the treatment group. After 6 months (324 +/- 127 kPa) and 1 year (380 +/- 190 kPa) a pressure reduction was found. Between the 6- and 12-month controls plantar pressures again increased. In the control group a significant increase of all peak pressures occurred.
Early insole support is successful in reducing plantar pressure. A repeated adjustment should be performed every 6 months to prevent foot pressure increases. The comparison of foot pressure development between the two groups showed constant levels in the treatment group. In the control group a marked increase of the pressure values was found. Identification and subsequent support of patients with high ulceration risk may help to reduce the high amputation rate.
本研究在为期1年的前瞻性观察期内，分析了特制鞋垫对糖尿病患者足部压力的影响。
我们研究了81例无足部病变的2型糖尿病患者。使用足底压力测量法，对三个不同的感兴趣区域进行了检查：全足区域的最大峰值压力（MPP）、足跟区域以及第一至第三跖骨头。18例高风险压力患者（全足MPP为474±183 kPa；足跟区域为278±147 kPa，跖骨为389±222 kPa）接受了最佳鞋垫支撑。63例患者作为对照组（全足MMP为367.7±157 kPa；足跟为263.1±127 kPa，跖骨为339.9±171 kPa）穿着传统鞋类。
在鞋垫支撑后，治疗组全足MMP压力降低了30%（474±183 kPa对290±106 kPa）。在6个月（324±127 kPa）和1年（380±190 kPa）后发现压力降低。在6个月至12个月的对照期间，足底压力再次升高。在对照组中，所有峰值压力均显著增加。
早期鞋垫支撑成功降低了足底压力。应每6个月进行一次重复调整，以防止足部压力增加。两组之间足部压力发展的比较显示，治疗组压力水平保持恒定。在对照组中，发现压力值显著增加。识别并随后对高溃疡风险患者提供支撑可能有助于降低高截肢率。
