Rehabilitation Engineering Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA; Department of Creative Product Design, Asia University, Taichung, Taiwan.
Rehabilitation Engineering Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
J Tissue Viability. 2020 May;29(2):61-68. doi: 10.1016/j.jtv.2020.03.003. Epub 2020 Mar 17.
Diabetic foot ulcers (DFUs) are one of the most serious complications of diabetes mellitus (DM). Although research has improved understanding of DFU etiology, an effective clinical prevention and management of DFUs remains undetermined. Knowledge of recent technologies may enable clinicians and researchers to provide appropriate interventions to prevent and treat DFUs. This paper discusses how diabetes causes peripheral neuropathy and peripheral arterial diseases, which contribute to increased risk of DFUs. Then, emerging technologies that could be used to quantify risks of DFUs are discussed, including laser Doppler flowmetry for assessing plantar tissue viability, infrared thermography for early detection of plantar tissue inflammation, plantar pressure and pressure gradient system for identification of specific site at risk for DFUs, and ultrasound indentation tests (elastography) to quantify plantar tissue mechanical property. This paper also reviews how physical activity reduces risks of DFUs and how technology promotes adherence of physical activity. The clinician should encourage people with DM to exercise (brisk walking) at least 150 min per week and assess their exercise log along with the blood glucose log for providing individualized exercise prescription. Last, rehabilitation interventions such as off-loading devices, thermotherapy and electrotherapy are discussed. Although the exact etiology of DFUs is unclear, the emerging technologies discussed in this paper would enable clinicians to closely monitor the change of risk of DFUs and provide timely intervention. An integrated approach using all these emerging technologies should be promoted and may lead to a better outcome of preventing and managing DFUs.
糖尿病足溃疡（DFU）是糖尿病（DM）最严重的并发症之一。尽管研究已经提高了对 DFU 病因的认识，但 DFU 的有效临床预防和管理仍未确定。对新技术的了解可能使临床医生和研究人员能够提供适当的干预措施来预防和治疗 DFU。本文讨论了糖尿病如何导致周围神经病变和外周动脉疾病，从而增加了 DFU 的风险。然后，讨论了可能用于量化 DFU 风险的新兴技术，包括激光多普勒流量测量仪评估足底组织活力、红外热成像术早期检测足底组织炎症、足底压力和压力梯度系统识别 DFU 高危特定部位，以及超声压痕试验（弹性成像）量化足底组织力学特性。本文还回顾了体育活动如何降低 DFU 的风险以及技术如何促进体育活动的依从性。临床医生应鼓励 DM 患者每周至少进行 150 分钟的快走运动，并根据血糖日志评估他们的运动记录，以提供个性化的运动处方。最后，讨论了康复干预措施，如减压装置、热疗和电疗。尽管 DFU 的确切病因尚不清楚，但本文讨论的新兴技术将使临床医生能够密切监测 DFU 风险的变化，并及时进行干预。应该推广使用所有这些新兴技术的综合方法，这可能会导致预防和管理 DFU 的更好结果。
