Bagherzadeh Cham Masumeh, Mohseni-Bandpei Mohammad Ali, Bahramizadeh Mahmood, Kalbasi Saeed, Biglarian Akbar
Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences, Tehran, Iran; Department of Orthotics & Prosthetics, Iran University of Medical Sciences, Tehran, Iran.
Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan.
Clin Biomech (Bristol). 2018 Nov;59:34-39. doi: 10.1016/j.clinbiomech.2018.08.007. Epub 2018 Aug 18.
The first aim of this study was to determine the effect of a vibro-medical insole on pressure sensation and the second was to measure the effects of a vibro-medical insole with and without random noise on plantar pressure distribution in diabetic patients with mild-to-moderate peripheral neuropathy.
Twenty patients with mild-to-moderate diabetic neuropathy were recruited in the clinical trial pre-test, post-test study. A medical insole was made for each participant and a vibratory system was inserted into it. Pressure sensation was evaluated before and after the 30-min walk using the vibro-medical insole with added random noise by Semmes-Weinstein Monofilaments. Peak pressure data was measured before and after 30-min walking with a vibro-medical insole with and without random noise by the Pedar-x system.
Pressure sensations showed improvement after 30-min walking with the vibro-medical insole with added random noise at the heel, metatarsophalangeal heads and hallux of both feet in all participants (p < 0.05). Peak pressure decreased significantly in the heel, MTP, MTP and hallux (p < 0.05) and increased in midfoot (p < 0.05) using the vibro-medical insole with and without random noise compared to the shoe only condition. Only the peak pressure of the heel region decreased using the vibro-medical insole with random noise compared to without random noise (p = 0.006).
Thirty minute walking with a vibro-medical insole seems to improve pressure sensation and alter peak pressure in diabetic patients with mild-to-moderate peripheral neuropathy. This work suggests that vibro-medical insoles can be used for daily living activities and possibly decreases the risk of ulceration in diabetic neuropathy patients.
本研究的首要目的是确定振动医疗鞋垫对压力感觉的影响，其次是测量有无随机噪声的振动医疗鞋垫对轻至中度周围神经病变糖尿病患者足底压力分布的影响。
在这项临床试验的前测-后测研究中招募了20名轻至中度糖尿病神经病变患者。为每位参与者制作了一个医疗鞋垫，并在其中插入了一个振动系统。使用添加了随机噪声的振动医疗鞋垫，通过Semmes-Weinstein单丝在30分钟步行前后评估压力感觉。使用Pedar-x系统测量在有和没有随机噪声的振动医疗鞋垫上步行30分钟前后的峰值压力数据。
在所有参与者中，使用添加了随机噪声的振动医疗鞋垫步行30分钟后，双脚后跟、跖趾关节头部和拇趾处的压力感觉均有改善（p<0.05）。与仅穿鞋子的情况相比，使用有和没有随机噪声的振动医疗鞋垫时，足跟、第一跖趾关节、第二跖趾关节和拇趾处的峰值压力显著降低（p<0.05），而足中部的峰值压力增加（p<0.05）。与没有随机噪声的振动医疗鞋垫相比，使用有随机噪声的振动医疗鞋垫时，仅足跟区域的峰值压力降低（p=0.006）。
对于轻至中度周围神经病变的糖尿病患者，使用振动医疗鞋垫步行30分钟似乎可改善压力感觉并改变峰值压力。这项研究表明，振动医疗鞋垫可用于日常生活活动，并可能降低糖尿病神经病变患者发生溃疡的风险。
