Janisse D J
National Pedorthic Services, Inc, Milwaukee, Wisconsin, USA.
Clin Podiatr Med Surg. 1995 Jan;12(1):41-61.
Current research emphasizes the importance of prevention in caring for the diabetic foot. Prescription footwear has been shown to be a significant factor in prevention of both ulcer recurrence and amputation. In addition, scientific evidence demonstrates the ability of insole materials to reduce shock and shear, the effectiveness of insoles in providing pressure relief, and the ability of rocker soles to relieve metatarsal pressure. This evidence, however, is limited and is often based on clinical investigation rather than on objective, quantitative measurements. Recent advances in biomechanical modeling and in-shoe pressure measurement should allow more objective data on a wider variety of prescription footwear to become available. The importance of prescription footwear as a preventive measure is nonetheless widely recognized. The knowledge and experience of pedorthists make them uniquely qualified to provide the needed shoes, modifications, and insoles for the long-term management of the diabetic foot.
当前的研究强调了预防在糖尿病足护理中的重要性。已证明定制鞋类是预防溃疡复发和截肢的一个重要因素。此外，科学证据表明鞋垫材料具有减轻冲击和剪切力的能力，鞋垫在提供压力缓解方面的有效性，以及摇椅底缓解跖骨压力的能力。然而，这些证据有限，且往往基于临床研究而非客观的定量测量。生物力学建模和鞋内压力测量方面的最新进展应能提供更多关于各种定制鞋类的客观数据。尽管如此，定制鞋类作为一种预防措施的重要性已得到广泛认可。足病矫形师的知识和经验使他们具备独特的资质，能够为糖尿病足的长期管理提供所需的鞋子、改良措施和鞋垫。
