足底压力测量研究全接触软石膏和全接触石膏对足底糖尿病足溃疡的卸载效果

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-04-01 DOI:10.1016/j.clinbiomech.2025.106511

Kor H. Hutting , Bastiaan P. Vierhout , Rene Visser , Richte C.L. Schuurmann , Mostafa El Moumni , Jeff G. van Baal , Jaap J. van Netten , Jean-Paul P.M. de Vries

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引用次数: 0

摘要

背景：全接触软石膏是一种治疗足底糖尿病足溃疡的减压装置。与传统的膝盖高的全接触铸件相比，全接触软铸件更短，更轻，并具有部分柔韧性。然而，其减压效果尚不清楚。方法采用全接触软石膏、全接触石膏和患者自己穿的鞋，测量糖尿病足溃疡患者溃疡处和6个足底区平均足底压力峰值。采用视觉模拟量表调查患者报告的舒适度。我们纳入了20例患者。溃疡部位的平均峰值足底压力在总接触软石膏中明显更高(中位数，505千帕；四分位数范围，319；628千帕斯卡)比总接触铸造(中位数，320千帕斯卡；四分位数范围，182；606千帕斯卡；p = 0.011)。除后脚外，所有足底区域的平均峰值足底压力均高于全接触软铸。与患者自己穿的鞋相比，总接触软鞋的足底压力峰值在拇趾、脚趾和足中部较低。行走时患者报告的舒适视觉模拟量表得分在总接触软投射中显著更好(中位数，8.8；四分位数范围，6.8;9.4)比全接触铸造(中位数，3.8；四分位数间距，1.7;4.9；p & lt;0.001)。解释：在糖尿病足溃疡部位和除后脚外的所有足底足区，全接触软石膏的足底压力峰值明显高于全接触石膏。患者报告的舒适感在完全接触软铸中更好。由于报道的全接触软石膏的临床结果是有利的，进一步的前瞻性研究是必要的。

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Plantar pressure measurements to investigate the offloading effect of total contact softcast and total contact cast for plantar diabetic foot ulcers

Background

Total contact softcast is an offloading device for plantar diabetic foot ulcers. Compared with conventional knee-high total contact casts, the total contact softcast is shorter, lighter, and partially flexible. However, its pressure offloading effects are unknown.

Methods

In patients with plantar diabetic foot ulcers, mean peak plantar pressure was measured at the ulcer and 6 plantar foot regions in total contact softcast, total contact cast, and patient's own footwear. Patient-reported comfort was investigated using a visual analogue scale.

Findings

We included 20 patients. Mean peak plantar pressure at the ulcer site was significantly higher in total contact softcast (median, 505 kilopascal; interquartile range, 319;628 kilopascal) than in total contact cast (median, 320 kilopascal; interquartile range, 182;606 kilopascal; p = 0.011). Mean peak plantar pressure in total contact softcast was higher in all plantar regions except for the hindfoot. Peak plantar pressures were lower in total contact softcast than in patient's own footwear at the hallux, toes, and midfoot. Patient-reported comfort visual analogue scale scores during walking were significantly better in total contact softcast (median, 8.8; interquartile range, 6.8;9.4) than in total contact cast (median, 3.8; interquartile range, 1.7;4.9; p < 0.001).

Interpretation

Peak plantar pressure was significantly higher in total contact softcast than in total contact cast at the diabetic foot ulcer site and all plantar foot regions, except the hindfoot. Patient-reported comfort was better in total contact softcast. Because reported clinical outcomes of total contact softcast are favorable, further prospective investigation is warranted.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.