Hemmati Fatemeh, Tafti Nahid, Nourouzi Ehsan, Turk Sajad Bayat, Karimi Mohammad Taghi, Sharifmoradi Keyvan, Kashani Reza Vahab
*University of Social Welfare and Rehabilitation Science, Tehran, Islamic Republic of Iran.
†School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran.
J Am Podiatr Med Assoc. 2023 May-Jun;113(3). doi: 10.7547/20-222.
Individuals with diabetic neuropathy may experience plantar ulcers and postural instability. Although use of an insole with arch support has the potential to decrease the incidence of plantar ulcers, the choice of proper design and material density concerning postural stability is challenging. The objective of this pilot study was to conduct a preliminary evaluation of the immediate effects of custom-made ethyl vinyl acetate insoles with arch support and Shore A values of 30 or 50 on static balance in patients with diabetes and neuropathic foot/feet.
Ten women with diabetes participated in this study. Static balance was analyzed while in double-limb standing with eyes closed and eyes open and while standing on a dominant limb with eyes open wearing shoes only and wearing shoes and insoles with Shore A values of 30 and 50.
With insole, the mean values of center of pressure excursions decreased significantly while standing on double limbs with eyes closed. The improvement in static balance was greater while using the insole with greater density; however, the difference was not statistically significant.
An insole with arch support made of ethyl vinyl acetate Shore A of 30 and 50, which could decrease plantar pressure concentration, had no negative effect on the static balance of diabetes. Therefore, further research on the long-term effects of such insoles on the static balance of diabetes is suggested.
糖尿病神经病变患者可能会出现足底溃疡和姿势不稳。尽管使用带有足弓支撑的鞋垫有可能降低足底溃疡的发生率，但在姿势稳定性方面选择合适的设计和材料密度具有挑战性。这项初步研究的目的是对定制的、足弓支撑且邵氏A硬度值为30或50的乙烯-醋酸乙烯酯鞋垫对糖尿病合并神经性足病患者静态平衡的即时效果进行初步评估。
10名患有糖尿病的女性参与了本研究。在双脚闭眼和睁眼双下肢站立时，以及在优势侧下肢睁眼仅穿鞋子和穿有邵氏A硬度值为30和50的鞋子及鞋垫站立时，对静态平衡进行分析。
使用鞋垫时，闭眼双下肢站立时压力中心偏移的平均值显著降低。使用密度更大的鞋垫时静态平衡的改善更大；然而，差异无统计学意义。
由邵氏A硬度值为30和50的乙烯-醋酸乙烯酯制成的带足弓支撑的鞋垫可降低足底压力集中，对糖尿病患者的静态平衡没有负面影响。因此，建议进一步研究此类鞋垫对糖尿病患者静态平衡的长期影响。
