Department of Biomechanics, University of Nebraska Omaha, 6001 Dodge St, Omaha, Nebraska 68182, USA.
Department of Diabetes, Endocrinology, and Metabolism, University of Nebraska Medical Center, 984130 Nebraska Medical Center, Omaha, NE 68198, USA.
Gait Posture. 2022 Oct;98:56-61. doi: 10.1016/j.gaitpost.2022.08.018. Epub 2022 Aug 24.
Patients with diabetic foot ulcers are instructed to be non-weight bearing on the affected limb to promote healing. Therefore, the aim of this study was to investigate the effect of different assistive devices on whole foot plantar loading, peak forefoot force, ankle range of motion, and locomotion speed during gait in patients with Type 2 Diabetes Mellitus.
Participants walked normally, with crutches, a walker, and a wheeled knee walker (WKW) in randomized order. Force sensitive insoles and 3D motion capture were used to record plantar normal force and ankle kinematics. Force sensitive pads were wrapped around handles of the crutches and walker to measure bodyweight offloaded onto the assistive device. An instrumented WKW was used to measure bodyweight offloaded onto the handlebars and knee cushion.
Locomotion with the WKW produced the lowest whole foot plantar loading and peak forefoot force in the propulsive limb, while also producing the greatest ankle range of motion and locomotion speed amongst assistive devices.
This pre-clinical study found that the WKW could be the preferred assistive device for total unilateral offloading of diabetic foot ulcers as it reduced propulsive limb whole foot and forefoot plantar loading while retaining ankle range of motion and locomotion speed.
患有糖尿病足溃疡的患者被指示不负重于受影响的肢体，以促进愈合。因此，本研究的目的是调查不同助行器对 2 型糖尿病患者在步态中整个足部足底负重、前足部峰值力、踝关节活动范围和运动速度的影响。
参与者以随机顺序正常行走、使用拐杖、助行器和带轮膝行器（WKW）。力敏鞋垫和 3D 运动捕捉用于记录足底正常力和踝关节运动学。力敏垫缠绕在拐杖和助行器的手柄上，以测量辅助设备上的体重卸载量。使用带仪器的 WKW 测量手柄和膝垫上的体重卸载量。
使用 WKW 进行行走时，在推进肢体中产生的整个足部足底负重和前足部峰值力最低，同时在辅助设备中产生的踝关节活动范围和运动速度最大。
这项临床前研究发现，WKW 可以作为糖尿病足溃疡的首选辅助装置，因为它可以减少推进肢体的整个足部和前足部足底负重，同时保持踝关节活动范围和运动速度。
