Ayumi Amemiya1, Hiroshi Noguchi2, Makoto Oe3, Yumiko Ohashi4, Kohjiro Ueki5, Takashi Kadowaki5, Taketoshi Mori6, Hiromi Sanada1. 1. The University of Tokyo, Department of Wound Care Management, Graduate School of Medicine, Japan. 2. The University of Tokyo, Department of Life Support Technology (Molten), Graduate School of Medicine, Japan. 3. The University of Tokyo, Department of Advanced Nursing Technology, Graduate School of Medicine, Japan. 4. The University of Tokyo Hospital, Department of Nursing, Japan. 5. The University of Tokyo, Department of Diabetes and Metabolic Diseases, Japan. 6. The University of Tokyo, Department of Life Support Technology (Molten), Graduate School of Medicine, Japan. Electronic address: tmoriics-tky@umin.ac.jp.
Abstract
PURPOSE: High plantar pressure is a major risk factor for diabetic foot ulcers. The relationship between plantar pressure and foot mobility has been investigated in some studies. However, when the foot is in motion, foot mobility is only a small feature of the gait. Therefore, we investigated relationship between high plantar pressure and gait and also studied the motion of the trunk. In addition, we investigated the relationship between gait and patient characteristics to identify patients at high-risk of developing diabetic foot ulcers. METHODS: The relationships between elevated plantar pressure, gait features, and patient characteristics were analyzed. Plantar pressure distribution in the stance phase was divided on the four plantar segments. Elevated plantar pressure was defined as being more than the mean plus one standard deviation of the corresponding segment in non-diabetic subjects. Plantar pressure distribution was measured by an F-scan system, and gait features were measured using wireless motion sensors attached to the sacrum and feet. Patient characteristics were obtained from medical records or by interview. RESULTS: Small roll and yaw motions of the body and yaw motion of the foot during the mid-stance phase were related to the elevated plantar pressure in 57 diabetic patients. Furthermore, these gait features were related to sensory neuropathy, diabetes duration, patient weight, toe-gap force, and ankle range of motion. CONCLUSION: Given our findings, it may be possible to prevent diabetic foot ulcers by increasing foot motion during the mid-stance phase. Passive exercise aimed at expanding ankle range of motion in patients with sensory neuropathy or long-standing diabetes may assist in achieving this.
PURPOSE: High plantar pressure is a major risk factor for diabetic foot ulcers. The relationship between plantar pressure and foot mobility has been investigated in some studies. However, when the foot is in motion, foot mobility is only a small feature of the gait. Therefore, we investigated relationship between high plantar pressure and gait and also studied the motion of the trunk. In addition, we investigated the relationship between gait and patient characteristics to identify patients at high-risk of developing diabetic foot ulcers. METHODS: The relationships between elevated plantar pressure, gait features, and patient characteristics were analyzed. Plantar pressure distribution in the stance phase was divided on the four plantar segments. Elevated plantar pressure was defined as being more than the mean plus one standard deviation of the corresponding segment in non-diabetic subjects. Plantar pressure distribution was measured by an F-scan system, and gait features were measured using wireless motion sensors attached to the sacrum and feet. Patient characteristics were obtained from medical records or by interview. RESULTS: Small roll and yaw motions of the body and yaw motion of the foot during the mid-stance phase were related to the elevated plantar pressure in 57 diabeticpatients. Furthermore, these gait features were related to sensory neuropathy, diabetes duration, patient weight, toe-gap force, and ankle range of motion. CONCLUSION: Given our findings, it may be possible to prevent diabetic foot ulcers by increasing foot motion during the mid-stance phase. Passive exercise aimed at expanding ankle range of motion in patients with sensory neuropathy or long-standing diabetes may assist in achieving this.
Authors: Animesh Hazari; Arun G Maiya; K N Shivashankara; Ioannis Agouris; Ashma Monteiro; Radhika Jadhav; Sampath Kumar; C G Shashi Kumar; Shreemathi S Mayya Journal: Springerplus Date: 2016-10-19
Authors: Qiu-Qiong Shi; Pui-Ling Li; Kit-Lun Yick; Jiao Jiao; Qi-Long Liu Journal: Int J Environ Res Public Health Date: 2022-09-30 Impact factor: 4.614