Zhu H, Wertsch J J, Harris G F, Alba H M, Price M B
Department of Biomedical Engineering, Marquette University, Milwaukee, WI.
Arch Phys Med Rehabil. 1993 Dec;74(12):1362-8. doi: 10.1016/0003-9993(93)90094-q.
In the individual with loss of protective sensation, the presence of high plantar pressures has been considered a risk factor for the development of plantar ulceration. Previous studies of insensate plantar pressures have measured a limited number of isolated, barefoot steps in a laboratory setting. Such isolated snapshots of barefoot plantar pressures do not give us insight into possible step-to-step variations or what plantar pressures occur when wearing shoes. The purpose of this study was to quantitatively examine and compare in-shoe plantar pressures during continuous walking by normal sensate and diabetic insensate subjects. A portable, insole data-acquisition system was used for pressure measurement during 4 minutes of normal continuous walking. Seven pressure sensors were placed in each insole under posterior and anterior heels, the metatarsal heads, and hallux. Twelve sensate and five insensate subjects were studied. We found that the insensate group had higher plantar pressures under posterior and anterior heels and the first metatarsals compared with the sensate group. From the study of the coefficients of variation, we demonstrated a larger step-to-step variation in plantar pressures for the insensate during continuous walking, suggesting the need for caution in interpreting the data from isolated force plate steps when studying insensate individuals.
对于失去保护性感觉的个体，足底压力过高被认为是发生足底溃疡的一个风险因素。先前关于无感觉足底压力的研究在实验室环境中测量了有限数量的孤立、赤脚行走步数。这种孤立的赤脚足底压力快照无法让我们深入了解可能的步间变化，也无法得知穿鞋时会出现何种足底压力。本研究的目的是定量检查和比较正常有感觉和糖尿病无感觉受试者在持续行走过程中的鞋内足底压力。在正常连续行走的4分钟内，使用便携式鞋垫数据采集系统进行压力测量。每个鞋垫在足跟前后、跖骨头和拇趾下方放置七个压力传感器。研究了12名有感觉的受试者和5名无感觉的受试者。我们发现，与有感觉的组相比，无感觉的组在足跟前后和第一跖骨下方的足底压力更高。通过对变异系数的研究，我们证明了无感觉的个体在持续行走过程中足底压力的步间变化更大，这表明在研究无感觉个体时，在解释来自孤立测力板步数的数据时需要谨慎。
