Elgohary Hany M, Allam Ibtsam, Tolba Ahmed M N, Ali Faten, Alwhaibi Reem M, Zakaria Hoda M, Ragab Walaa M, Elbalawy Youssef
Physical Therapy Department, Faculty of Applied Medical Sciences, Jerash University, Jerash 26110, Jordan.
Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo 12613, Egypt.
Medicina (Kaunas). 2024 Dec 16;60(12):2066. doi: 10.3390/medicina60122066.
Patients with diabetes polyneuropathy are at a heightened risk for developing foot ulcers, often due to dynamic plantar foot pressure patterns that lead to increased pressure and shear forces in specific foot areas. This study aimed to evaluate the effects of foot insoles on peak pressure and the pressure-time integral in patients with polyneuropathy diabetic foot ulcers over a twelve-week period followed by an eight-week follow up. : This was a prospective, randomized, double-blinded, controlled clinical trial involving 60 patients aged between 50 and 65 years of both genders. Inclusion criteria included midfoot ulcer grades II or III, a history of polyneuropathy diabetic foot ulcers lasting between six months and one year, diabetes duration of seven to ten years, glycated hemoglobin levels between 7% and 9%, and a body mass index (BMI) ranging from 25 to 30 kg/m. Participants were randomly assigned to either the study group, which received foot insoles along with medication and wound care, or the control group, which received only medication and wound care. Measurements of peak pressure and pressure-time integrals were taken at the start of this study, after twelve weeks, and again eight weeks post-study. : The results indicated significant differences in peak pressure and pressure-time integral measurements for the rearfoot, midfoot, hallux, and both medial and lateral forefoot areas after twelve weeks of using foot insoles compared to the control group. This suggests that the use of foot insoles effectively reduces peak pressure and the pressure-time integral in these critical areas. : The findings of this study support the use of foot insoles as a beneficial intervention for decreasing peak pressure and the pressure-time integral on the hallux, medial, and lateral forefoot in patients with polyneuropathic diabetic foot ulcers, and they could play a crucial role in preventing further complications.
糖尿病多发性神经病变患者发生足部溃疡的风险较高,这通常是由于动态足底压力模式导致特定足部区域的压力和剪切力增加所致。本研究旨在评估鞋垫对糖尿病性足部溃疡合并多发性神经病变患者在12周治疗期及随后8周随访期内的峰值压力和压力-时间积分的影响。:这是一项前瞻性、随机、双盲、对照临床试验,纳入了60名年龄在50至65岁之间的男女患者。纳入标准包括中足溃疡II级或III级、糖尿病性足部溃疡合并多发性神经病变病史持续6个月至1年、糖尿病病程7至10年、糖化血红蛋白水平在7%至9%之间以及体重指数(BMI)在25至30kg/m之间。参与者被随机分为研究组和对照组,研究组接受鞋垫以及药物治疗和伤口护理,对照组仅接受药物治疗和伤口护理。在本研究开始时、12周后以及研究结束8周后测量峰值压力和压力-时间积分。:结果表明,与对照组相比,使用鞋垫12周后,后足、中足、拇趾以及前足内侧和外侧区域的峰值压力和压力-时间积分测量值存在显著差异。这表明使用鞋垫可有效降低这些关键区域的峰值压力和压力-时间积分。:本研究结果支持将鞋垫作为一种有益的干预措施,用于降低糖尿病性足部溃疡合并多发性神经病变患者拇趾、前足内侧和外侧的峰值压力和压力-时间积分,并且它们在预防进一步并发症方面可能发挥关键作用。