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《麻风病患者足底压力与感觉障碍的关系:初步研究及文献回顾》

Relationship between Plantar Pressure and Sensory Disturbance in Patients with Hansen's Disease-Preliminary Research and Review of the Literature.

机构信息

Department of Rehabilitation, National Sanatorium Tamazenshoen, Higashi-Murayama, Tokyo 189-0002, Japan.

Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan.

出版信息

Sensors (Basel). 2020 Dec 6;20(23):6976. doi: 10.3390/s20236976.

Abstract

Orthoses and insoles are among the primary treatments and prevention methods of refractory plantar ulcers in patients with Hansen's disease. While dynamic plantar pressure and tactile sensory disturbance are the critical pathological factors, few studies have investigated whether a relationship exists between these two factors. In this study, dynamic pressure measured using F-scan system and tactile sensory threshold evaluated with monofilament testing were determined for 12 areas of 20 feet in patients with chronic Hansen's disease. The correlation between these two factors was calculated for each foot, for each clinical category of the foot (0-IV) and across all feet. A significant correlation was found between dynamic pressure and tactile sensation in Category II feet ( = 8, = 0.016, r = 0.246, Spearman's rank test). In contrast, no significant correlation was detected for the entire foot or within the subgroups for the remainder of the clinical categories. However, the clinical manifestation of lesion areas showed high variability: (1) pressure concentrated, sensation lost; (2) margin of pressure concentration, sensation lost; (3) pressure concentrated, sensation severely disturbed but not lost; and (4) tip of the toe. These results may indicate that, even though there was a weak relationship between dynamic pressure and tactile sensation, it is important to assess both, in addition to the basics of orthotic treatment in patients with Hansen's disease presenting with refractory plantar ulceration.

摘要

矫形器和鞋垫是治疗和预防麻风病患者难治性足底溃疡的主要方法之一。动态足底压力和触觉感觉障碍是关键的病理因素,但很少有研究调查这两个因素之间是否存在关系。在这项研究中,使用 F-scan 系统测量动态压力,并用单丝测试评估触觉感觉阈值,共评估了 20 只脚的 12 个区域。计算了每只脚、每只脚的临床类别(0-IV)和所有脚这两个因素之间的相关性。在 II 类脚部( = 8, = 0.016,r = 0.246,Spearman 等级检验)中发现动态压力和触觉之间存在显著相关性。相比之下,在整个脚部或其余临床类别亚组中未检测到显著相关性。然而,病变区域的临床表现表现出高度的可变性:(1)压力集中,感觉丧失;(2)压力集中的边缘,感觉丧失;(3)压力集中,感觉严重受损但未丧失;和(4)脚趾尖。这些结果可能表明,尽管动态压力和触觉之间存在弱相关性,但在为患有难治性足底溃疡的麻风病患者进行矫形治疗时,除了基本治疗外,还需要评估这两者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbc8/7730212/db7e0b460d2e/sensors-20-06976-g001.jpg

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