| Objective1. Understand the plantar pressure distribution characteristics of type2diabetes mellitus (T2DM) patients with peripheral neuropathy (DPN) patients.2. To observe the plantar pressure distribution of type2diabetic patients in forward walking and backward walking, explore the significance of backwarding that may exit.3. To study the effect of backward-walking training joint alpha-lipoic acid(ALA) treatment on the distribution of plantar pressure of the patients with Diabetic peripheral neuropathy.Methods1. Select91normal controls (group NC),74patients with diabetes (group DM) and83diabetic patients with peripheral neuropathy (group DN) from hospital.Use Footscan Flatbed system test the plantar peak pressure and impulse to.2. A total of114patients with T2DM(group DM),and83healthy people(group NC) during the same period. Use Footscan Flatbed system test the subject to study normal subjects and diabetic patients in the natural forward walking and backward walking process in the dynamic plantar pressure distribution characteristics.3. Sixty patients with DPN were divided into experimental group(n=30),and control group(n=30).The experimental group was treated with backward walking exercise joint alpha-lipoic acid, and the control group only given lipoic acid treatment(Lipoic acid for2weeks,Backward-walking exercise for12weeks).Plantar pressure before and after the experiment were tested with the flatbed plantar pressure.To understand the characteristics of the plantar pressure distribution by the plantar peak pressure.Results1. Normal human plantar peak pressure and the impulse of the highest value in M2,and the diabetes group in M3.In addition to M3,no significant difference between the peak pressure and the normal group of the remaining part of the diabetic group.Early in DM, peak pressure slightly elevated in patients with non-peripheral neuropathy M3and M5. With the progression of patients with significant peripheral nerve damage.M3and M5peak pressure further increased,Tl has also been increased,while the MF peak pressure drop. Impulse changes similar.2.(1)Forward walking:diabetic group compared with the control group were increased regional peak foot pressure in the metatarsal1,3(M1,M3),heel medial(HM).And M3is the highest.(2)Forward walking:Compared with control group,feet of diabetic group in the toe1(T1),metatarsal1to5(M1to M5),foot central arch or mid foot(MF),heel medial(HM) and heel lateral(HL) increased impulse.The M3area increased most significantly.(3)Compared with forward walking,backwarding in the diabetic patients with T1,T2-5,M1,MF,HM and HL peak pressure have different degrees of increase,but peak pressure is significantly reduced in the M3.(4)Compared with forward walking,feet T1and T2-5increased impulse in the diabetic group when forwarding,especially in the T1zone;but feet M2,M3,M4impulse is less than the same parts of impulse in the forward walking, especially in the M3zone.3.(1)The clinical efficacy of the control group and the experimental group was no significant difference(x2=0.523,P>0.05).(2)Before treatment:The feet of the control group and the experimental group in the corresponding region of the peak pressure were not statistically different.(3)After treatment:the experimental group compared with the control group,peak pressure decreased significantly in both feet M1and M3area,and the same with the left foot in M2.(4)The control group:After treatment compared with before treatment, the M5area of the left foot peak pressure decreased, but the peak pressure area in the M1of left foot and right foot M3has risen.(5)The experimental group:Before and after treatment,the peak pressure of both feet in the M1decreased after treatment,the M2and M3areas of the left foot also declined,however the MF area of the left foot and the HL area of the right foot were elevated.Conclusion1. Changes in dynamic plantar pressure in patients with diabetic peripheral neuropathy lower arch, metatarsal peak pressure and impulse abnormally high levels, possible increased risk of foot ulcers.2.Compared with normal subjects, patients with diabetes plantar peak pressure and impulse distribution is different. Backward walking can significantly improve the plantar force and ease the forefoot force.3. Patients with diabetic peripheral neuropathy after treatment of lipoic acid and backward walking exercise, the forefoot withstand the pressure significantly lower,the distribution plantar pressure is more uniform.However, the combination therapy is better. |
