Department of Nursing Physiology, Graduate School of Nursing, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8672, Japan.
Department of Nursing, Hospital of Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Oomiya-ku, Saitama-shi, Saitama 330-8503, Japan.
Sensors (Basel). 2018 Sep 28;18(10):3269. doi: 10.3390/s18103269.
Excessive pressure and shear stress while walking cause a risk of callus formation, which eventually causes foot ulcers in patients with diabetes mellitus. Callus under the second metatarsal head (MTH) has been associated with increased shear stress/pressure ratios (SPR). Callus under the fifth MTH has been associated with increased peak shear stress (PSS). The purpose of this study is to examine whether the effect of the suitable size and width of shoes prevents diabetic foot ulcers under the second and fifth MTH. We measured the pressure and shear stress by testing three kinds of sizes and two types of width of shoes. Significant difference was not observed in the SPR under the second MTH among different sizes of shoes. However, the pressure and shear stress were significantly lower when putting on shoes of fit size compared with larger sizes. The PSS under the fifth MTH was significantly smaller when putting on shoes of fit width compared with those of narrow width. Wearing shoes of fit size and width has the potential to prevent callus formation by reducing the pressure and shear stress constituting SPR under the second MTH and PSS under the fifth MTH.
行走时过大的压力和切变力会增加胼胝形成的风险,从而导致糖尿病患者足部溃疡。第二跖骨头(MTH)下的胼胝与较高的切变力/压力比(SPR)有关。第五 MTH 下的胼胝与较高的峰值切变力(PSS)有关。本研究旨在探讨合适尺寸和宽度的鞋子是否能预防第二和第五 MTH 下的糖尿病足溃疡。我们通过测试三种尺寸和两种宽度的鞋子来测量压力和切变力。不同尺寸的鞋子在第二 MTH 下的 SPR 没有观察到显著差异。然而,与较大尺寸的鞋子相比,穿上合适尺寸的鞋子时压力和切变力明显降低。与窄宽度的鞋子相比,穿上合适宽度的鞋子时第五 MTH 下的 PSS 明显更小。穿合适尺寸和宽度的鞋子有可能通过降低构成第二 MTH 下的 SPR 和第五 MTH 下的 PSS 的压力和切变力来预防胼胝形成。