Bioengineering College and Department of Endocrinology, Chongqing University Central Hospital, Key Laboratory for Biorheological Science and Technology of Ministry of Education, Chongqing University, Chongqing, China.
Department of Endocrinology, Ankang Central Hospital, Ankang, China.
Gerontology. 2021;67(4):493-502. doi: 10.1159/000513729. Epub 2021 Mar 3.
Using specials wearable sensors, we explored changes in gait and balance parameters, over time, in elderly patients at high risk of diabetic foot, wearing different types of footwear. This assessed the relationship between gait and balance changes in elderly diabetic patients and the development of foot ulcers, in a bid to uncover potential benefits of wearable devices in the prognosis and management of the aforementioned complication.
A wearable sensor-based monitoring system was used in middle-elderly patients with diabetes who recently recovered from neuropathic plantar foot ulcers. A total of 6 patients (age range: 55-80 years) were divided into 2 groups: the therapeutic footwear group (n = 3) and the regular footwear (n = 3) group. All subjects were assessed for gait and balance throughout the study period. Walking ability and gait pattern were assessed by allowing participants to walk normally for 1 min at habitual speed. The balance assessment program incorporated the "feet together" standing test and the instrumented modified Clinical Test of Sensory Integration and Balance. Biomechanical information was monitored at least 3 times.
We found significant differences in stride length (p < 0.0001), stride velocity (p < 0.0001), and double support (p < 0.0001) between the offloading footwear group (OG) and the regular footwear group on a group × time interaction. The balance test embracing eyes-open condition revealed a significant difference in Hip Sway (p = 0.004), COM Range ML (p = 0.008), and COM Position (p = 0.004) between the 2 groups. Longitudinally, the offloading group exhibited slight improvement in the performance of gait parameters over time. The stride length (odds ratio 3.54, 95% CI 1.34-9.34, p = 0.018) and velocity (odds ratio 3.13, 95% CI 1.19-8.19, p = 0.033) of OG patients increased, converse to the double-support period (odds ratio 6.20, 95% CI 1.97-19.55, p = 0.002), which decreased.
Special wearable devices can accurately monitor gait and balance parameters in patients in real time. The finding reveals the feasibility and effectiveness of advanced wearable sensors in the prevention and management of diabetic foot ulcer and provides a solid background for future research. In addition, the development of foot ulcers in elderly diabetic patients may be associated with changes in gait parameters and the nature of footwear. Even so, larger follow-up studies are needed to validate our findings.
使用特殊的可穿戴传感器，我们研究了高风险糖尿病足的老年患者在不同类型的鞋具下，随时间推移步态和平衡参数的变化。这旨在揭示老年糖尿病患者步态和平衡变化与足部溃疡发展之间的关系，以期发现可穿戴设备在上述并发症的预后和管理方面的潜在益处。
使用基于可穿戴传感器的监测系统对近期患有神经病变性足底溃疡的中老年糖尿病患者进行监测。共有 6 名患者（年龄 55-80 岁）分为两组：治疗性鞋具组（n=3）和常规鞋具组（n=3）。所有受试者在整个研究期间都进行步态和平衡评估。通过让参与者以习惯速度正常行走 1 分钟来评估行走能力和步态模式。平衡评估方案包括“双脚并拢”站立测试和仪器化改良临床感觉综合和平衡测试。至少进行 3 次生物力学信息监测。
我们发现，在组间×时间交互作用方面，减压鞋具组（OG）和常规鞋具组之间的步幅长度（p<0.0001）、步速（p<0.0001）和双支撑（p<0.0001）存在显著差异。在包含睁眼条件的平衡测试中，OG 组 Hip Sway（p=0.004）、COM Range ML（p=0.008）和 COM Position（p=0.004）的差异具有统计学意义。纵向来看，减压组随时间的推移，步态参数的表现略有改善。OG 患者的步幅长度（优势比 3.54，95%置信区间 1.34-9.34，p=0.018）和速度（优势比 3.13，95%置信区间 1.19-8.19，p=0.033）增加，而双支撑期（优势比 6.20，95%置信区间 1.97-19.55，p=0.002）则减少。
特殊的可穿戴设备可以实时准确地监测患者的步态和平衡参数。这一发现揭示了先进的可穿戴传感器在预防和管理糖尿病足溃疡方面的可行性和有效性，为未来的研究提供了坚实的基础。此外，老年糖尿病患者的足部溃疡发展可能与步态参数的变化和鞋具的性质有关。尽管如此，仍需要更大规模的随访研究来验证我们的发现。
