本文選題：糖尿病鞋 + 神經(jīng)病變�。� 參考：《北京體育大學》2014年碩士論文

【摘要】：研究目的：糖尿病患者異常的足底壓力分布會造成足底潰瘍的風險,而合適的鞋對糖尿病患者的足部能起到改善足底壓力分布,降低潰瘍風險的作用。本研究通過對比糖尿病患者穿著一種糖尿病鞋和普通鞋時的動態(tài)足底壓力變化,分析該糖尿病鞋對于糖尿病患者足底壓力分布的影響。 研究方法：參與實驗的受試者均為男性,其中糖尿病神經(jīng)病變組(病變組)11名,糖尿病無神經(jīng)病變組(病控組)13名,健康對照組(對照組)15名。首先使用footscan足底壓力平板測試3組受試者赤足行走行走時的足底壓力,了解有神經(jīng)病變的糖尿病患者和無神經(jīng)病變的糖尿病患者的足底壓力分布特征。然后讓糖尿病神經(jīng)病變患者和糖尿病無神經(jīng)病變患者分別穿普通鞋和糖尿病鞋進行鞋內(nèi)壓測試和鞋外壓測試。鞋內(nèi)壓測試使用Novel-Pedar鞋墊式壓力測試系統(tǒng),鞋外壓測試使用footscan足底壓力平板。兩種鞋的測試順序隨機。運用SPSS軟件中的獨立樣本t檢驗檢驗赤足行走測試的數(shù)據(jù),運用重復測量方差分析檢驗穿鞋測試的數(shù)據(jù),統(tǒng)計結(jié)果的顯著性水平為P0.05。 研究結(jié)果：赤足行走時,病變組與病控組趾骨區(qū)中部的標準化峰值壓強顯著低于對照組；病變組和對照組赤足行走時全足平衡曲線在y軸上的峰值顯著更大。無論穿普通鞋還是穿糖尿病鞋,病變組在趾骨區(qū)的標準壓強時間積分都顯著大于病控組；而穿糖尿病鞋的兩組受試者在足中部的標準化峰值壓力和標準化壓力時間積分都顯著大于穿普通鞋時。 研究結(jié)論：(1)赤足行走狀態(tài)下糖尿病神經(jīng)病變患者趾骨區(qū)中部的標準化峰值壓強顯著低于健康對照組。與健康對照組相比,糖尿病神經(jīng)病變患者和糖尿病非神經(jīng)病變患者赤足行走時在蹬離地階段更傾向內(nèi)側(cè)用力。 (2)糖尿病神經(jīng)病變患者在趾骨區(qū)的壓強時間積分顯著大于糖尿病非神經(jīng)病變患者。糖尿病神經(jīng)病變患者足中部著地時間顯著比糖尿病非神經(jīng)病變患者短。 (3)糖尿病神經(jīng)病變患者跖骨區(qū)的鞋內(nèi)壓標準化壓強時間積分顯著高于糖尿病無神經(jīng)病變患者。兩組受試者穿糖尿病鞋時足中部峰值壓力和壓力時間積分都大于穿普通鞋時,而跖骨區(qū)和后跟區(qū)的沖量與穿普通鞋時無顯著差異。
[Abstract]:Objective: abnormal plantar pressure distribution in diabetic patients may result in the risk of plantar ulcers, and proper shoes can improve the foot pressure distribution and reduce the risk of ulceration in diabetic patients. In this study, the effect of diabetic shoes on foot pressure distribution in diabetic patients was analyzed by comparing the dynamic sole pressure changes between a diabetic shoe and a common shoe. Methods: all the subjects were male, including 11 diabetic neuropathy group, 13 diabetic non-neuropathy group and 15 healthy control group. First, the plantar pressure of three groups of subjects walking barefoot was measured with footscan plantar pressure plate to understand the characteristics of foot pressure distribution in diabetic patients with neuropathy and diabetic patients without neuropathy. Then the patients with diabetic neuropathy and the patients without diabetic neuropathy were asked to wear common shoes and diabetic shoes to test the internal pressure of shoes and the external pressure of shoes respectively. Novel-Pedar insole pressure test system was used in shoe inner pressure test and footscan sole pressure plate was used for shoe external pressure test. The test sequence of two kinds of shoes is random. The data of barefoot walking test was tested by independent sample t-test in SPSS software, and the data of shoe wear test was tested by repeated measurement variance analysis. The significant level of the statistical result was P0.05. Results: the standardized peak pressure in the middle of phalanx was significantly lower in the lesion group and the disease control group than in the control group, and the peak value of the balance curve of the whole foot in the y axis was significantly larger in the lesion group and the control group. Whether wearing common shoes or wearing diabetic shoes, the standard pressure time integral in the phalangeal area in the lesion group was significantly higher than that in the disease control group. The standardized peak pressure and standardized pressure time score in the middle of the foot were significantly higher in the diabetic shoes group than in the normal shoes group. Conclusion the standardized peak pressure in the middle of the phalanx was significantly lower in the patients with diabetic neuropathy under barefoot walking than that in the healthy control group. Compared with the healthy control group, diabetic neuropathy patients and diabetic non-neuropathy patients were more inclined to the medial force when walking barefoot. 2) the pressure time integral of diabetic neuropathy patients was significantly higher than that of diabetic non-neuropathy patients. The time of landing in the middle of the foot in diabetic neuropathy patients was significantly shorter than that in non-diabetic neuropathy patients. 3) the time integral of standardized pressure in the metatarsal area of patients with diabetic neuropathy was significantly higher than that in patients without diabetic neuropathy. The peak pressure and pressure time score in the middle part of the foot were higher than those in the normal shoe, but the impulse in the metatarsal area and heel area had no significant difference between the two groups.
【學位授予單位】：北京體育大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R587.2;R318.01

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