한국정밀공학회지 (Journal of the Korean Society for Precision Engineering)

  • 제24권1호
  • /
  • Pages.118-125
  • /
  • 2007
  • /
  • 1225-9071(pISSN)
  • /
  • 2287-8769(eISSN)
한국정밀공학회 (Korean Society for Precision Engineering)
권호 표지

외측 뒤꿈치 당뇨발 환자의 보행 중 발바닥 전단응력 및 압력분포

Plantar Shear Stress and Normal Pressure in Lateral Heel Diabetic Foot Patients During Walking

  • 황성재 (연세대학교 대학원 의공학과) ;
  • 박선우 (연세대학교 대학원 의공학부) ;
  • 이진복 (한서대학교 의료보장구학과) ;
  • 류기홍 (연세대학교 대학원 의공학과) ;
  • 김영호 (연세대학교 의공학부, 연세의료공학연구원)
  • 발행 : 2007.01.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

In this study, we analyzed the plantar shear stress and normal pressure in lateral heel diabetic foot patients during walking by using in-shoe local shear stress and plantar pressure measurement systems. The shear force transducer based on the magnetic-resistive principle, was a rigid 3-layer circular disc. Shear transducers were mounted on the locations of four metatarsal heads and heel in the insole. Twelve normal subjects and three diabetic foot patients with diabetic neuropathy in the lateral heel participated in this study. The center of pressure in lateral heel diabetic foot patients moved more medially and directed toward the first, medial to the second metatarsal heads, and the hallux during late stance, making pressure at the medial heel and the second metatarsal head significantly larger than in the normal. Shear stress at the heel changed significantly in early stance and the magnitude of shear stresses in each metatarsal head also changed. Further studies would be very helpful to design foot orthoses in patients with diabetic neuropathy or other diseases.

키워드

참고문헌

  1. Kim, Y. G., 'The Diabetic Foot Lesions,' Diabetologia, Vol. 19, No.1, pp. 1-5, 1995
  2. Lee, C. T., 'The Diabetic Foot,' ChoiShin Medical Book, pp. 23-26, 2000
  3. Veves, A., Murray, H. J., Young, M. J. and Boulton, A. J., 'The Risk of Foot Ulceration in Diabetic Patients with High Foot Pressure: a Prospective Study,' Diabetologia, Vol. 35, No.7, pp. 660-663, 1992 https://doi.org/10.1007/BF00400259
  4. Medved, V., 'Measurement of Human Locomotion,' CRC Press, pp. 157-168, 2001
  5. Stephen, U., 'Plantar Pressure-measurement Sensors,' IOP Published Ltd, pp. 1-31, 1999
  6. Reichel, S. M., 'Shearing Force as a Factor in Decubitus Ulcers in Paraplegics,' Arch. Phys. Med. Rehab., Vol. 166, No.3, pp. 762-763, 1958
  7. Dinsdale, S. M., 'Decubitus Ulcers : Role of Pressure and Friction in Causation,' Arch. Phys. Med. Rehab., Vol. 55, No.4, pp. 147-152, 1974
  8. Bennett, L., Kavner, D., Lee, B. Y. and Trainor, F. A., 'Shear vs Pressure as Causative Factors in Skin Blood Flow Occlusion,' Arch. Phys. Med. Rehab., Vol. 60, No.7, pp. 309-314, 1979
  9. Bennett, L., Kavner, D., Lee, B. Y., Trainor, F. S. and Lewis, J. M., 'Skin Stress and Blood Flow Sitting Paraplegic Patients,' Arch. Phys. Med. Rehab., Vol. 65, No.4, pp. 492-498, 1984
  10. Goossens, R. H., Snijders, C. J., Hoek van Dijke, G. A. and den Ouden, A. H., 'A New Instrument to Measure Force in Beds and Seats,' J. Biomed. Eng., Vol. 15, No.5, pp. 409-412, 1994 https://doi.org/10.1016/0141-5425(93)90078-D
  11. Goossens, R. H. and Snijders, C. J., 'Shear Stress Measurement on Beds and Wheelchairs,' J. Rehab. Med., Vol. 29, No.1, pp. 131-136, 1997
  12. Kemozek, T. W. and Lamott, E. E., 'Comparisons of Plantar Pressures between the Elderly and Young Adults,' Gait and Posture, Vol. 3, No.3, pp. 143-148, 1995 https://doi.org/10.1016/0966-6362(95)99064-R
  13. Kwon, C. H., Park, S. B. and Kim, Y. H., 'Characteristics of Dynamic Plantar Pressure Distribution in Foot Deformities: Flat Foot and Pes Cavus,' KOSOMBE, Vol. 18, No.4, pp. 439-446, 1997
  14. Tappin, J. W., Pollard, J. and Beckett, E., 'A Method of Measuring Shearing Forces on the Sole of the Foot,' Clin. Phys. Physiol. Meas., Vol. 1, No. 1, pp. 80-85, 1980
  15. Hosein, R. and Lord, M., 'A Study of In-shoe Plantar Shear in Normals,' Clinical Biomechanics, Vol. 15, No.1, pp. 546-531, 2000 https://doi.org/10.1016/S0268-0033(00)00003-6
  16. Lord, M. and Hosein, R., 'Method for In-shoe Shear Stress Measurement,' J. Biomed. Eng., Vol. 14, No.3, pp. 181-186, 1992 https://doi.org/10.1016/0141-5425(92)90049-Q
  17. Jung, I. S., Ahn, S. C., Lee, J. B., Kim, H. S. and Kim, Y. H., 'A Development of an Insole Type Local Shear Measurement Transducer and Measurements of Local Plantar Shear Force During Gait,' Journal of the Korean Society of Precision Engineering, Vol. 22, No.6, pp. 213-221, 2005