老年糖尿病患者的足底压力及步态特征

《中国组织工程研究》 Chinese Journal of Tissue Engineering Research736 ·研究原著·卜月丽，女，1992年生，山东省五莲县人，汉族，2019年天津科技大学毕业，硕士，主要从事人体生物力学研究。

通讯作者：王芳，副教授，天津科技大学机械工程学院，天津市 300222；天津市轻工与食品工程机械装备集成设计与在线监控重点实验室，天津市 300222并列通讯作者：张建国，硕士，教授，天津科技大学机械工程学院，天津市 300222；天津市轻工与食品工程机械装备集成设计与在线监控重点实验室，天津市 300222文献标识码:B投稿日期：2019-04-08 送审日期：2019-04-17 采用日期：2019-05-31 在线日期：2019-08-31Bu Yueli, Master, College of Mechanical Engineering, Tianjin University of Science & Technology, Tianjin 300222, ChinaCorresponding author: Wang Fang, Associate professor, College of Mechanical Engineering, Tianjin University of Science & Technology, Tianjin 300222, China; Tianjin Key Laboratory of Integrated Design and OnlineMonitoring for Light Industry & Food Machinery and Equipment, Tianjin 300222, China老年糖尿病患者的足底压力及步态特征卜月丽1，王 芳1，2，张建国1，2，李晓林1，曹子君1，李雪梅3(1天津科技大学机械工程学院，天津市 300222；2天津市轻工与食品工程机械装备集成设计与在线监控重点实验室，天津市 300222；3天津医科大学代谢病医院，天津市 300070) DOI:10.3969/j.issn.2095-4344.1928 ORCID: 0000-0001-5815-4684(卜月丽)文章快速阅读：文题释义：老年糖尿病患者：糖尿病指以慢性高血糖为特征的代谢性疾病，是一种广泛流行于全世界的慢性疾病。

老年糖尿病患者是指年龄≥60周岁的糖尿病患者。

足底压力：具体指当人体处于静止站立或动态行走的状态时，足部受到一个在竖直方向上来自地面的反作用力，这个力就被称为足底压力。

摘要背景：研究表明，足底压力是糖尿病足溃疡的主要危险因素之一。

目的：探讨老年糖尿病患者自然步态下足底压力特征及差异性，为老年患者足部的监测和足部减压产品设计提供数据支撑。

方法：研究方案的实施符合天津医科大学代谢病医院对研究的相关伦理要求，所有受试者均对试验过程完全知情同意。

通过鞋垫式足底压力检测系统对年龄≥60周岁的41位老年糖尿病患者和30位老年健康者自然步态下的足底压力进行检测。

观察足部峰值压力、峰值时间百分比、X 偏移量、Y 偏移量、包络压力中心点95%椭圆置信面积、步频、步速、步幅长、站立相、摆动相。

结果与结论：①与老年健康组相比，老年糖尿病组峰值压力集中在第2-4跖骨区显著增大，左足多数足区峰值时间百分比减小，右足足跟区、中足区峰值时间百分比增大(P < 0.05)；②与老年健康组相比，老年糖尿病组站立相降低，摆动相升高，步频降低，男性步幅长增大，步速加快，女性步幅长减小，步速减慢；③老年糖尿病组包络压力中心点95%椭圆置信面积较老年健康组呈减小趋势，老年糖尿病组X 、Y 偏移量大于老年健康组；④结果说明：老年糖尿病患者身体稳定性和灵活性较正常老年人降低，足底压力明显由足跟向跖骨部位转移，在足部护理中需加强对跖骨区足底压力的重视。

关键词：老年糖尿病患者；足底压力；步态；峰值压力；足部减压 中图分类号：R446；R496；R318Plantar pressure and gait characteristics in older adult patients with diabetesBu Yueli 1, Wang Fang 1, 2, Zhang Jianguo 1, 2, Li Xiaolin 1, Cao Zijun 1, Li Xuemei 3 (1College of Mechanical Engineering, Tianjin University of Science & Technology, Tianjin 300222, China; 2Tianjin Key Laboratory of Integrated Design and Online Monitoring for Light Industry & Food Machinery and Equipment, Tianjin 300222, China; 3Metabolic Disease Hospital, Tianjin Medical University, Tianjin 300070, China)AbstractBACKGROUND: Plantar pressure is one of the major risk factors for diabetic foot ulcers.OBJECTIVE: To explore the characteristics of plantar pressure under natural gait in older adult patients with diabetes and compare them with those in healthy older adults, providing data for preventing foot diseases and designing foot decompression products.METHODS: The study protocol was performed in accordance with the Medical Ethics Committee of TianjinMedical University, China. Forty-one older adult patients with diabetes and 30 healthy older adults, both aged over 60 years, received plantar pressure detection using an insole-type root pressure measurement system. Peak老年糖尿病组峰值压力集中在第2-4跖骨区，峰值时间百分比在左足多足区减小，右足老年糖尿病组站立相降低，摆动相升高，步频降低，男性步幅长增大，步速加快，女性步包络压力中心点95%椭圆置信面积呈减小趋势，足底压力测量BU YL, WANG F , ZHANG JG , LI XL, CAO ZJ, LI XM. Plantar pressure and gait characteristics in older adult patients with diabetes.Zhongguo Zuzhi Gongcheng Yanjiu. 2020;24(5):736-740. DOI:10.3969/j.issn.2095-4344.1928737plantar pressure, percentage of peak time, X offset, Y offset, 95% confidence ellipse area, step frequency, step velocity, stride length, standing phase, and swing phase were measured. After fully understanding the study protocol, each participant provided written informed consent.RESULTS AND CONCLUSION: Compared with healthy older adults, peak plantar pressure was significantly increased in the 2nd -4thmetatarsal region, the peak time was decreased in most area of the left foot and increased in the right root heel and arch area in older adult patients with diabetes (P < 0.05). Compared with healthy older adults, standing phase was decreased, swing phase was increased, step frequency was decreased, stride length in males was increased, step velocity was increased, stride length in females was decreased, and step velocity was decreased in older adult patients with diabetes. Compared with healthy older adults, 95% confidence ellipse area wasdecreased, and X offset and Y offset were increased in older adult patients with diabetes. These results suggest that the stability and flexibility of older adult patients with diabetes are lower than those of healthy older adults. In older adult patients with diabetes, plantar pressure is obviously transferred from the heel to the humerus. Therefore, much attention should be paid to plantar pressure in foot care. Key words: older adult patients with diabetes; plantar pressure; gait; peak pressure; foot decompression0 引言 Introduction由于人口老龄化和生活方式的改变，糖尿病患病率正在增加，随着年龄增长，全球糖尿病患病率从65-70岁人群的12%增加到了80岁人群的15%[1]。