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【medical-news】糖尿病足溃疡：个体化治疗鞋垫可
"Not all insoles are equal," Dr. Georgeanne Botek from Cleveland Clinic in Ohio told Reuters Health. "With increased numbers of sites making insoles and dispensing shoes, researching who has a special interest in preventing foot ulceration and preserving ambulation and function is important. Pre-fabricated devices, store-bought insoles, and even orthotic laboratory 'customized' insoles vary depending on the prescription and lab."
Dr. Botek and colleagues investigated whether combining the foot shape measurement with the placement of offloading features, on the basis of quantitative measurements, led to an insole design that achieves better off-loading than the current shape-based approach.
The design based on foot shape and plantar pressure measurements achieved superior unloading compared with two designs based on foot shape alone, the authors report, both with flexible shoes and with rocker shoes.
The insoles developed using the new design approach relieved peak pressure at the regions of interest by 21% to 37% more than insoles made with the current design approach.
In the flexible shoe, the new insoles significantly increased peak pressure and force-time integral in the midfoot, the investigators say, whereas they significantly increased only the force-time integral in the rocker shoe.
"Larger metatarsal pads or bars can transfer more of the load to the midfoot," Dr. Botek explained. "Also, rocker soles are more effective at offloading high pressure points."
"Technology is advancing" and computer-based software holds the promise of "having orthotics made at the point of service, using equipment that can translate patient information to a distant site that can create a more specific, customized insole more efficiently and effectively than stepping in a foam box and mailing to a distant orthotics laboratory," Dr. Botek said.
"We have a registry of patients who have ulcerated within the past year," Dr. Botek added. "I hope to have a randomized trial with resolved ulcers, having one group of patients fitted with custom molded insoles based on foot shape, and the other group of patients fitted with the shape and pressure based insoles. We can then look at re-ulceration rates of both groups."
Diabetes Care 2008;31:839-844. 认领一下 NEW YORK (Reuters Health) May 27 - Custom therapeutic insoles enhance plantar pressure relief in high-pressure areas under the forefoot, according to a report in the May issue of Diabetes Care.
纽约（路透社 健康）5月27日-据5月份的糖尿病护理杂志报道，个体化治疗鞋垫可以减轻前脚压力。
"Not all insoles are equal," Dr. Georgeanne Botek from Cleveland Clinic in Ohio told Reuters Health. "With increased numbers of sites making insoles and dispensing shoes, researching who has a special interest in preventing foot ulceration and preserving ambulation and function is important. Pre-fabricated devices, store-bought insoles, and even orthotic laboratory 'customized' insoles vary depending on the prescription and lab."
“并不是多有的鞋垫都是一样的，”来自俄亥俄州克利夫兰诊所的乔治 .布特可博士告诉路透社健康报。“随着生产和分发鞋垫的地点越来越多，那些对预防足部溃疡和保留足部行走功能的研究者是很重要的。预制的图案、商店的鞋垫、甚至连实验室一贯用的矫正的鞋垫都是根据处方和实验室结果的不同而变化的。
Dr. Botek and colleagues investigated whether combining the foot shape measurement with the placement of offloading features, on the basis of quantitative measurements, led to an insole design that achieves better off-loading than the current shape-based approach.
布特可博士及其同事通过定量研究，调查了是否可以通过将脚的形状测量与其重力作用部位结合起来，设计一种鞋垫，比现在以形状为基础设计的鞋垫更好的分卸压力。
The design based on foot shape and plantar pressure measurements achieved superior unloading compared with two designs based on foot shape alone, the authors report, both with flexible shoes and with rocker shoes.
笔者报道，同样用有柔韧性和弯底鞋，基于脚的形状和足底压力测量的设计，相比与单纯根据脚的形状的两种设计可以更好的减少足底的压力。
The insoles developed using the new design approach relieved peak pressure at the regions of interest by 21% to 37% more than insoles made with the current design approach.
根据新方案设计的鞋垫可以比目前方案设计的鞋垫将重要部位的最高压力多减少21% 到 37%。
In the flexible shoe, the new insoles significantly increased peak pressure and force-time integral in the midfoot, the investigators say, whereas they significantly increased only the force-time integral in the rocker shoe.
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作者:admin@医学,生命科学 2010-10-07 17:11
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