基于足形与足底压力的老年糖尿病危险足护足鞋具的设计与应用研究

Design and Application Evaluation of Foot Protective Shoes for Elderly Patients with Diabetic Foot Risk Based on Foot Shape and Plantar Pressure

目的 设计基于足形与足底压力的老年糖尿病危险足护足鞋具,并评价其应用效果,以期为预防足溃疡的发生提供有效护具。方法 通过文献回顾、研究团队的前期研究、专家意见以及预实验确定鞋具的设计方案。在上海市长宁区某社区卫生服务中心招募老年糖尿病危险足患者96例,按随机数字表法分为对照组和观察组。对照组穿着根据鞋码统一制作的老人鞋,观察组穿着依据护足鞋具设计方案制作的鞋具,干预3个月。干预前后评估两组患者赤足及穿鞋状态下的足底峰值压力、冲量以及足底压力中心轨迹(center of pressure, COP)曲线等指标。结果 干预后,观察组患者赤足及穿鞋状态下的足底峰值压力均低于对照组(均P<0.05);赤足状态下左、右足的最大冲量、总冲量均低于对照组(均P<0.05);COP曲线异常比例低于对照组(P<0.05),差异均有统计学意义。结论 基于足形与足底压力设计的老年糖尿病危险足护足鞋具,能有效降低患者的足底峰值压力、冲量及改善足底压力中心轨迹,对预防足溃疡具有积极意义。

Objective To design and evaluate the foot protective shoes for elderly patients with diabetic foot risk based on foot shape and plantar pressure, and to provide effective protective footwear for preventing foot ulcers.Methods Through literature review, preliminary research, expert opinions and pre-experiment, the design scheme of footwear for elderly patients with diabetic foot risk was constructed.96 elderly patients with diabetic foot risk were recruited to evaluate the application effect of footwear from a community service center in Changning District, Shanghai, and the patients were divided into control group and observation group according to random number table.The control group wore shoes made according to shoe size, and the observation group wore the shoes made according to the design scheme of foot protective shoes.The intervention time was 3 months.Plantar peak pressure, impulse and center of pressure(COP) trajectory were evaluated before and after the intervention.Results After intervention, the plantar peak pressure of the observation group was lower than that of the control group in barefoot and in shoes(all P< 0.05).The maximum impulse and total impulse of the left and right foot in the bare condition in the observation group were lower than those in the control group(all P<0.05).The abnormal ratio of the COP trajectory of the observation group was lower than that of the control group(P<0.05).Conclusions The protective shoes designed based on foot shape and plantar pressure for elderly patients with diabetic foot risk can effectively reduce the patients’ plantar peak pressure, impulse and improve the COP trajectory, which is of positive significance for the prevention of foot ulcers.