López-Moral M, Molines-Barroso R J, Álvaro-Afonso F J, Uccioli L, Senneville E, Lázaro-Martínez J L
Diabetic Foot Unit, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
Diabetic Foot Unit, Department Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
J Clin Med. 2020 Mar 25;9(4):907. doi: 10.3390/jcm9040907.
We aimed to identify if any differences existed in spatiotemporal parameters during gait among different densities of rocker soles in patients with a history of neuropathic ulcerations and the differences in comfort between shoe conditions. This study was a cross-sectional study of 24 patients with diabetes and a history of neuropathic diabetic foot ulcers (DFUs). Spatiotemporal parameters (duration of stance phase (ms), stride length (cm), and step velocity (m/s)) were analyzed in barefoot, semirigid outsole, and rigid outsole footwear conditions. A dynamic pressure measurement system (Footscan system, RSscan International, Belgium) was used to assess shoe conditions. We also analyzed differences in comfort between the shoe conditions using a visual analog scale. A Wilcoxon test for paired samples was used to assess gait differences. Result showed that rigid outsole causes changes in the subphases of the stance phase ( < 0.001; Cohen d = 0.6) compared to a semirigid outsole. Stride length ( < 0.001; Cohen d = 0.66) and step velocity were significantly longer ( < 0.001; Cohen d = 2.03) with the use of rigid outsole footwear. A rigid rocker sole reduces the time of the stance phase, in addition to increasing the stride length and velocity of step in patients with a previous history of DFUs.
我们旨在确定有神经性溃疡病史的患者在穿着不同密度摇椅底鞋行走时的时空参数是否存在差异，以及不同鞋类条件下的舒适度差异。本研究是一项针对24例有糖尿病和神经性糖尿病足溃疡（DFUs）病史患者的横断面研究。在赤脚、半刚性外底鞋和刚性外底鞋条件下分析时空参数（站立期时长（毫秒）、步长（厘米）和步速（米/秒））。使用动态压力测量系统（Footscan系统，RSscan International，比利时）评估鞋类条件。我们还使用视觉模拟量表分析了不同鞋类条件下的舒适度差异。采用配对样本的Wilcoxon检验评估步态差异。结果显示，与半刚性外底相比，刚性外底会导致站立期各子阶段发生变化（<0.001；Cohen d = 0.6）。使用刚性外底鞋时，步长（<0.001；Cohen d = 0.66）和步速显著更长（<0.001；Cohen d = 2.03）。对于有DFUs病史的患者，刚性摇椅底不仅增加了步长和步速，还缩短了站立期时间。
