Gurney Jason K, Kersting Uwe G, Rosenbaum Dieter, Dissanayake Ajith, York Steve, Grech Roger, Ng Anthony, Milne Bobbie, Stanley James, Sarfati Diana
Cancer and Chronic Conditions (C3) Research Group, Department of Public Health, University of Otago, Wellington, New Zealand.
Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.
J Foot Ankle Res. 2017 Jun 9;10:24. doi: 10.1186/s13047-017-0205-6. eCollection 2017.
The peripheral complications of diabetes mellitus remain a significant risk to lower-limb morbidity. In New Zealand, risk of diabetes, comorbidity and lower-limb amputation are highly-differential between demographic groups, particularly ethnicity. There is growing and convincing evidence that the use of pedobarography - or plantar pressure measurement - can usefully inform diabetic foot care, particularly with respect to the prevention of re-ulceration among high-risk patients.
For the current feasibility study, we embedded pedobarographic measurements into three unique diabetic foot clinic settings in the New Zealand context, and collected pedobarographic data from = 38 patients with diabetes using a platform-based (Novel Emed) and/or in-shoe-based system (Novel Pedar). Our aim was to assess the feasibility of incorporating pedobarographic testing into the clinical care of diabetic feet in New Zealand.
We observed a high response rate and positive self-reported experience from participants. As part of our engagement with participants, we observed a high degree of lower-limb morbidity, including current ulceration and chronic foot deformities. The median time for pedobarographic testing (including study introduction and consenting) was 25 min. Despite working with a high-risk population, there were no adverse events in this study. In terms of application of pedobarography as a clinical tool in the New Zealand context, the current feasibility study leads us to believe that there are two avenues that deserve further investigation: a) the use of pedobarography to inform the design and effectiveness of offloading devices among high-risk diabetic patients; and b) the use of pedobarography as a means to increase offloading footwear and/or orthoses compliance among high-risk diabetic patients. Both of these objectives deserve further examination in New Zealand via clinical trial.
糖尿病的外周并发症仍然是下肢发病的重大风险。在新西兰，糖尿病、合并症和下肢截肢的风险在不同人群中存在很大差异，尤其是在种族方面。越来越多且令人信服的证据表明，使用足压力描记法——即足底压力测量——可为糖尿病足护理提供有益信息，特别是在预防高危患者再次溃疡方面。
在当前的可行性研究中，我们将足压力描记测量纳入新西兰的三个独特糖尿病足诊所环境中，并使用基于平台的（Novel Emed）和/或基于鞋内的系统（Novel Pedar）从38例糖尿病患者中收集足压力描记数据。我们的目的是评估在新西兰将足压力描记测试纳入糖尿病足临床护理的可行性。
我们观察到参与者的高响应率和积极的自我报告体验。作为与参与者互动的一部分，我们观察到下肢发病率很高，包括当前的溃疡和慢性足部畸形。足压力描记测试（包括研究介绍和同意过程）的中位时间为25分钟。尽管研究对象为高危人群，但本研究中未发生不良事件。就足压力描记法在新西兰作为一种临床工具的应用而言，当前的可行性研究使我们相信有两条途径值得进一步研究：a）使用足压力描记法为高危糖尿病患者的卸载装置的设计和有效性提供信息；b）使用足压力描记法作为提高高危糖尿病患者对卸载鞋类和/或矫形器依从性的一种手段。这两个目标都值得在新西兰通过临床试验进行进一步研究。
