Haris Fahni, Jan Yih-Kuen, Liau Ben-Yi, Hsieh Chang-Wei, Shen Wei-Cheng, Tai Chien-Cheng, Shih Yin-Hwa, Lung Chi-Wen
Department of Healthcare Administration, Asia University, Taichung, Taiwan.
School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia.
Front Bioeng Biotechnol. 2024 Mar 11;12:1353888. doi: 10.3389/fbioe.2024.1353888. eCollection 2024.
Clinically, air insoles may be applied to shoes to decrease plantar pressure gradient (PPG) and increase plantar gradient angle (PGA) to reduce foot ulcers. PPG and PGA may cause skin breakdown. The effects of different inner pressures of inflatable air insoles on dynamic PPG and PGA distributions are largely unknown in non-diabetics and people with diabetes. This study aimed to explore the impact of varying inner air insole pressures on PPG and PGA to establish early mitigation strategies for people at risk of foot ulcers. A repeated measures study design, including three air insoles (80 mmHg, 160 mmHg, and 240 mmHg) and two walking durations (10 and 20 min) for a total of six walking protocols, was tested on 13 healthy participants (height, 165.8 ± 8.4 cm; age, 27.0 ± 7.3 years; and weight, 56.0 ± 7.9 kg, BMI: 20.3 ± 1.7 kg/m^2) over three consecutive weeks. PPG, a measurement of the spatial variation in plantar pressure around the peak plantar pressure (PPP) and PGA, a variation in the gradient direction values at the three plantar regions, big toe (T1), first metatarsal head (M1), and second metatarsal head (M2), were calculated. This study indicated that PPG was lower at 80 mmHg air insoles after 20 min of walking in the M1 region ( = 0.010). The PGA in the M2 increased at an air insole of 80 mmHg compared to 240 mmHg ( = 0.015). Compared to 20 min, the 10 min walking duration at 240 mmHg of air insole had the lowest PPG in the M1 ( = 0.015) and M2 ( = 0.034) regions. The 80 mmHg air insole significantly lowered the PPG compared to a 160 mmHg and 240 mmHg air insole. Moreover, the 80 mmHg air insole significantly decreased PPP and increased PGA compared to the 160 mmHg and 240 mmHg air insole. A shorter walking period (10 min) significantly lowered PPG. The findings of this study suggest that people with a higher risk of foot ulcers should wear softer air insoles to have a lower PPG, as well as an increased PGA.
临床上，可将空气鞋垫应用于鞋子，以降低足底压力梯度（PPG）并增加足底梯度角（PGA），从而减少足部溃疡。PPG和PGA可能导致皮肤破损。在非糖尿病患者和糖尿病患者中，充气式空气鞋垫不同内部压力对动态PPG和PGA分布的影响在很大程度上尚不清楚。本研究旨在探讨空气鞋垫内部压力变化对PPG和PGA的影响，为有足部溃疡风险的人群制定早期缓解策略。对13名健康参与者（身高165.8±8.4厘米；年龄27.0±7.3岁；体重56.0±7.9千克，BMI：20.3±1.7千克/平方米）进行了一项重复测量研究设计，包括三种空气鞋垫（80毫米汞柱、160毫米汞柱和240毫米汞柱）和两种步行持续时间（10分钟和20分钟），共六种步行方案，连续测试三周。计算了PPG（一种围绕足底峰值压力（PPP）的足底压力空间变化测量值）和PGA（三个足底区域，即大脚趾（T1）、第一跖骨头（M1）和第二跖骨头（M2）处梯度方向值的变化）。本研究表明，在M1区域步行20分钟后，80毫米汞柱空气鞋垫的PPG较低（P = 0.010）。与240毫米汞柱相比，80毫米汞柱空气鞋垫时M2处的PGA增加（P = 0.015）。与20分钟相比，在240毫米汞柱空气鞋垫下步行10分钟时，M1（P = 0.015）和M2（P = 0.034）区域的PPG最低。与160毫米汞柱和240毫米汞柱空气鞋垫相比，80毫米汞柱空气鞋垫显著降低了PPG。此外，与160毫米汞柱和240毫米汞柱空气鞋垫相比，80毫米汞柱空气鞋垫显著降低了PPP并增加了PGA。较短的步行时间（10分钟）显著降低了PPG。本研究结果表明，足部溃疡风险较高的人群应穿着更柔软的空气鞋垫，以降低PPG，并增加PGA。
