摘要
目的 探讨下肢功能性训练对糖尿病足患者足-地接触面积、足底压力和冲量的影响,为糖尿病足的防控提供理论及实践依据。方法 纳入50~80岁糖尿病足受试者100名,健康受试者50名。将100名糖尿病足受试者分为下肢功能性训练组(HDG)和无训练阳性对照组(HCG),各50名;将50名健康受试者作为阴性对照组(NCG),以比较下肢功能性训练干预效果。HDG组接受4次/周、60 min/次,为期12周的下肢功能性训练干预,NCG组和HCG组接受常规护理及正常生活。用智能足型检测扫描仪进行足-地接触面积、足底压力和冲量指标测试和分析。结果 干预后,HDG组左足和右足第1趾(toe 1,T1)、第l跖骨(metatarsal 1,M1)、内侧足中部(mid foot, MF)、足跟内侧(heel medial, HM)和足跟外侧(heel lateral, HL)足-地接触面积均减小,左足和右足第2~5趾(T2~5)、第2~3跖骨(M2~3)、第4~5跖骨(M4~5)、外侧足中部(mid foot, MF)足-地接触面积均显著增加;干预后,HDG组左足和右足足底负荷、压力峰值、压力均值、前后足负荷比均显著减小;干预后,HDG组左足和右足T1、M1、M2~3、M4~5、内侧和外侧MF冲量显著降低,左足和右足T2~5、HM和HL冲量显著增加。结论 下肢功能性训练后,糖尿病足患者足底接触面积异常现象改善,足底压力峰值降低,足底压力冲量得到重新分配,减轻和延缓了步态中局部负荷过高引起足部溃疡的发生。研究结果有助于为糖尿病足患者提供不同的下肢康复和锻炼方法参考。
Objective To investigate the effects of lower limb functional training on foot-ground contact area,plantar pressure and impulse in patients with diabetic foot,and provide theoretical and practical basis for the prevention and control of diabetic foot.Methods A total of 100 subjects with diabetic foot aged 50 to 80 years old and 50 healthy subjects were included.The 100 subjects with diabetic foot were divided into a lower limb functional training group(HDG group),and a no-training positive control group(HCG group),each with 50 subjects,and 50 healthy subjects as a negative control group(NCG group)to compare the effects of the lower limb functional training interventions.The HDG group received the 12-week lower limb functional training intervention 4 times/week,60 minutes/time.The NCG group and HCG group received routine care and normal life.Foot-ground contact area,plantar pressure and impulse metrics were tested and analyzed with the Intelligent Foot Detection Scanner.Results After the intervention,the foot-ground contact area at toe 1(T1),metatarsal 1(M1),mid foot(MF),heel medial(HM),and heel lateral(HL)region of the left and right foot in the HDG group was reduced,and the foot-ground contact area at toe 2-5(T2~5),metatarsal 2-3(M2~3),metatarsal 4-5(M4~5),and mid foot(MF)region of the left and right foot were significantly increased.After the intervention,plantar load,peak pressure,mean pressure,and forefoot to forefoot load ratio were significantly reduced in the left and right foot of the HDG group.After the intervention,impulses at T1,M1,M2~3,M4~5,medial,and lateral MF region of the left and right foot in the HDG group were significantly decreased in,and impulses at T2~5,HM,and HL region of the left and right foot in the HDG group were significantly increased.Conclusions After functional training of the lower limbs,the abnormalities of plantar contact area in patients with diabetic foot were improved,the peak plantar pressure was reduced,the plantar pressure impulse was redistributed,and the occurrence of foot ulcers caused by localized overloading in gait was mitigated and delayed.This study can help to provide a reference for different rehabilitation and exercise methods of lower limbs for patients with diabetic foot.
作者
蔡科
刘一平
CAI Ke;LIU Yiping(College of Physical Education&Health,Jiangxi Science and Technology Normal University,Nanchang 330038,China;Key Laboratory of Kinesiological Evaluation General Administration of Sport of China,School of Physical Education and Sport Science,Fujian Normal University,Fuzhou 350117,China)
出处
《医用生物力学》
北大核心
2025年第4期963-970,共8页
Journal of Medical Biomechanics
基金
国家社会科学基金项目(22BTY003)
福建省科技厅区域发展项目(2023Y3002)。
关键词
下肢功能性训练
糖尿病足
步态
足底压力
冲量
lower limb functional training
diabetic foot
gait
plantar pressure
impulse
