Spiess Kerianne E, Sansosti Laura E, Meyr Andrew J
Resident, Surgical Residency Program, Temple University Hospital, Philadelphia, PA.
Associate Professor, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.
J Foot Ankle Surg. 2017 May-Jun;56(3):573-576. doi: 10.1053/j.jfas.2017.01.043.
We have previously demonstrated an abnormally delayed mean brake response time and an increased frequency of abnormally delayed brake responses in a group of neuropathic drivers with diabetes compared with a control group of drivers with neither diabetes nor lower extremity neuropathy. The objective of the present case-control study was to compare the mean brake response time between 2 groups of drivers with diabetes with and without lower extremity sensorimotor neuropathy. The braking performances of the participants were evaluated using a computerized driving simulator with specific measurement of the mean brake response time and the frequency of the abnormally delayed brake responses. We compared a control group of 25 active drivers with type 2 diabetes without lower extremity neuropathy and an experimental group of 25 active drivers with type 2 diabetes and lower extremity neuropathy from an urban U.S. podiatric medical clinic. The experimental group demonstrated an 11.49% slower mean brake response time (0.757 ± 0.180 versus 0.679 ± 0.120 second; p < .001), with abnormally delayed reactions occurring at a greater frequency (57.5% versus 35.0%; p < .001). Independent of a comparative statistical analysis, diabetic drivers with neuropathy demonstrated a mean brake response time slower than a suggested safety threshold of 0.70 second, and diabetic drivers without neuropathy demonstrated a mean brake response time faster than this threshold. The results of the present investigation provide evidence that the specific onset of lower extremity sensorimotor neuropathy associated with diabetes appears to impart a negative effect on automobile brake responses.
我们之前已经证明，与一组既没有糖尿病也没有下肢神经病变的对照司机相比，一组患有糖尿病的神经性司机的平均制动反应时间异常延迟，且异常延迟制动反应的频率增加。本病例对照研究的目的是比较两组患有糖尿病的司机（有和没有下肢感觉运动神经病变）之间的平均制动反应时间。使用计算机驾驶模拟器对参与者的制动性能进行评估，具体测量平均制动反应时间和异常延迟制动反应的频率。我们比较了来自美国一家城市足病诊所的25名无下肢神经病变的2型糖尿病活跃司机对照组和25名患有2型糖尿病和下肢神经病变的活跃司机实验组。实验组的平均制动反应时间慢11.49%（0.757±0.180秒对0.679±0.120秒；p<0.001），异常延迟反应的发生频率更高（57.5%对35.0%；p<0.001）。独立于比较统计分析，患有神经病变的糖尿病司机的平均制动反应时间慢于建议的安全阈值0.70秒，而没有神经病变的糖尿病司机的平均制动反应时间快于该阈值。本研究结果提供了证据，表明与糖尿病相关的下肢感觉运动神经病变的特定发作似乎会对汽车制动反应产生负面影响。
