Jorgetto Juliana Vallim, Oggiam Daniella Silva, Gamba Mônica Antar, Kusahara Denise Miyuki
Department of Public Health in the Collective Dimension, Federal University of São Paulo - UNIFESP, Octávio Parreira Street, 100, Jardim das Paineiras / São João da Boa Vista-SP, São Paulo, CEP: 13,874-720 Brazil.
Retired teacher of Administration Applied to Nursing and Collective Health, School of Nursing, Federal University of São Paulo - UNIFESP, São Paulo, Brazil.
J Diabetes Metab Disord. 2022 Sep 16;21(2):1577-1589. doi: 10.1007/s40200-022-01104-1. eCollection 2022 Dec.
Diabetic neuropathy is one of the main complications of Diabetes Mellitus, which can lead to loss of protective sensation, motor, and plantar pressure alteration, generating deformities, abnormal gait and mechanical trauma to the feet.
to evaluate the distribution of plantar pressure, sensorimotor changes, balance and associated factors to plantar pressure changes in people with peripheral diabetic neuropathy.
Cross-sectional study conducted with individuals registered in the primary public health service of a city in the east of São Paulo - Brazil. The sample was composed by people with Diabetes Mellitus and Peripheral Neuropathy identified by the Michigan Screening Instrument. It were investigated variables such as sensory-motor changes, static and dynamic plantar pressure using baropodometry and balance using the Berg scale. A significance level of 5% was adopted for all tests used.
Of the 200 individuals evaluated, 52.55% had no plantar protective sensitivity, the static evaluation did not demonstrated changes in the peak of plantar pressure, however in the dynamics the mean in the right foot was 6.0 (±2) kgf/cm and 6,7 (±1.62) kgf/cm on the left foot, the center of static pressure on the right foot was lower (10.55 ± 3.82) than on the left foot (11.97 ± 3.90), pointing hyper plantar pressure. The risk of falling was high, ranging from 8 to 56 points, with an average of 40.9 (±10.77).
The absence of protective plantar sensitivity, increased pressure, biomechanical changes lead to loss of balance and are predictive of complications in the feet due to diabetic neuropathy.
糖尿病神经病变是糖尿病的主要并发症之一,可导致保护性感觉丧失、运动功能障碍以及足底压力改变,进而引发足部畸形、异常步态和机械性创伤。
评估糖尿病周围神经病变患者的足底压力分布、感觉运动变化、平衡能力以及与足底压力变化相关的因素。
对巴西圣保罗市东部一个城市的初级公共卫生服务机构登记的个体进行横断面研究。样本由通过密歇根筛查工具确诊为糖尿病和周围神经病变的患者组成。使用足底压力测量法研究感觉运动变化、静态和动态足底压力等变量,并使用伯格量表评估平衡能力。所有测试采用5%的显著性水平。
在评估的200名个体中,52.55%的人没有足底保护性感觉,静态评估未显示足底压力峰值有变化,但在动态评估中,右脚的平均值为6.0(±2)千克力/平方厘米,左脚为6.7(±1.62)千克力/平方厘米,右脚的静态压力中心(10.55±3.82)低于左脚(11.97±3.90),表明足底压力过高。跌倒风险较高,范围为8至56分,平均为40.9(±10.77)分。
足底保护性感觉缺失、压力增加、生物力学变化导致平衡能力丧失,是糖尿病神经病变足部并发症的预测因素。