Ahroni J H, Boyko E J, Forsberg R
Veterans Affairs Puget Sound Health Care System, Clinical Faculty, Department of Biobehavioral Nursing and Health Systems, Seattle, Washington 98108, USA.
Foot Ankle Int. 1998 Oct;19(10):668-73. doi: 10.1177/107110079801901004.
Research by our group and others indicates that many amputations of the lower limb occur after foot ulceration in patients with diabetes. It has been proposed that diabetic foot ulcers are mainly caused by repetitive trauma in areas of high plantar pressure during walking. Recent technology permits in-shoe measurement of plantar pressure. We assessed the reliability of the F-Scan in-shoe system for measurement of plantar pressure (Tekscan Inc., Boston, MA) in 51 subjects from a cohort of 977 diabetic veterans enrolled in a prospective study of risk factors for foot ulceration and amputation (the Seattle Diabetic Foot Study). Subjects were tested twice, wearing their own shoes. We used the coefficient of variation (CV) and the intra-class correlation coefficient (ICC) to estimate the reliability of F-Scan measurements of pressure. Peak pressure over the metatarsal heads proved to have the best indices of reliability, with CVs of 0.150 and 0.155, and ICCs of 0.755 and 0.751. Coefficients of variation for the heel, whole foot, and hallux ranged from 0.148 to 0.240, with ICCs ranging from 0.493 to 0.832. By published standards, peak pressures over the metatarsal heads and right hallux met the criteria for excellent reliability. Our ICCs for high pressures under the foot, heel, metatarsal heads, and hallux, and for peak pressures under the heel and left hallux represented fair-to-good reliability. No F-Scan plantar measurements could be judged by these criteria as having poor reliability. This clinical study found that for elderly patients with diabetes who were wearing their own shoes and were tested on two different days with different insoles, the F-Scan insole system was generally reliable for measurements of high pressure and peak pressure.
我们团队及其他机构的研究表明，糖尿病患者的许多下肢截肢发生在足部溃疡之后。有人提出，糖尿病足溃疡主要是由行走过程中足底压力较高区域的反复创伤所致。最新技术允许对足底压力进行鞋内测量。我们在977名参与足部溃疡和截肢危险因素前瞻性研究（西雅图糖尿病足研究）的糖尿病退伍军人队列中的51名受试者中，评估了用于测量足底压力的F-Scan鞋内系统（Tekscan公司，马萨诸塞州波士顿）的可靠性。受试者穿着自己的鞋子接受了两次测试。我们使用变异系数（CV）和组内相关系数（ICC）来估计F-Scan压力测量的可靠性。结果证明，跖骨头处的峰值压力具有最佳的可靠性指标，CV分别为0.150和0.155，ICC分别为0.755和0.751。足跟、全足和拇趾的变异系数范围为0.148至0.240，ICC范围为0.493至0.832。按照已发表的标准，跖骨头和右拇趾处的峰值压力符合极佳可靠性的标准。我们针对足底、足跟、跖骨头和拇趾下方的高压以及足跟和左拇趾下方的峰值压力所得到的ICC代表了中等至良好的可靠性。根据这些标准，没有F-Scan足底测量结果可被判定为可靠性差。这项临床研究发现，对于穿着自己的鞋子且在两天内使用不同鞋垫进行测试的老年糖尿病患者，F-Scan鞋垫系统在测量高压和峰值压力方面总体上是可靠的。
