Abstract：
BACKGROUND: Forty-three percent of all diabetic foot ulcers occur under the medial forefoot due to a medial deviation of elevated pressures and premature forefoot ground contact in neuropathic diabetic patients. A 6-week sensorimotor training period with an unstable shoe construction reduces in-shoe peak pressures and contact times under the medial aspect of the forefoot.
METHODS: The study was designed as a Randomised Control Trial with two diabetic groups (one served as intervention group and one as control group) and one non-diabetic intervention group. Measurements for barefoot pressure distribution and contact times were taken by means of an Emed® pressure measurement platform (Novel GmbH, Munich) before and after 6 weeks. During this time the diabetic and the non-diabetic intervention groups were required to wear an unstable shoe construction (Masai Barefoot Technology, MBT®) for at least four hours per day.
RESULTS: Results for the non-diabetic intervention group showed significantly later contact times for the medial portion of the forefoot, resulting in shorter contact times. Peak pressure was also reduced under the medial aspect of the foot while it was increased under the lateral aspect of the foot. Changes for the diabetic intervention group followed the same pattern while the values of the diabetic control group shifted away from the reference values.
CONCLUSIONS: A 6-week sensorimotor training period with an unstable shoe construction can change barefoot peak pressures and contact times in non-diabetic subjects and in diabetic patients in the most endangered area, i.e. the medial forefoot.
METHODS: The study was designed as a Randomised Control Trial with two diabetic groups (one served as intervention group and one as control group) and one non-diabetic intervention group. Measurements for barefoot pressure distribution and contact times were taken by means of an Emed® pressure measurement platform (Novel GmbH, Munich) before and after 6 weeks. During this time the diabetic and the non-diabetic intervention groups were required to wear an unstable shoe construction (Masai Barefoot Technology, MBT®) for at least four hours per day.
RESULTS: Results for the non-diabetic intervention group showed significantly later contact times for the medial portion of the forefoot, resulting in shorter contact times. Peak pressure was also reduced under the medial aspect of the foot while it was increased under the lateral aspect of the foot. Changes for the diabetic intervention group followed the same pattern while the values of the diabetic control group shifted away from the reference values.
CONCLUSIONS: A 6-week sensorimotor training period with an unstable shoe construction can change barefoot peak pressures and contact times in non-diabetic subjects and in diabetic patients in the most endangered area, i.e. the medial forefoot.
摘要：
背景：在神经性糖尿病患者中，43%的糖尿病足溃疡发生在前足内侧下，这是由于压力升高和前足早期地面接触的内侧偏离。为期6周的感觉运动训练期，鞋子结构不稳定，可减少鞋内峰值压力和前脚内侧的接触时间。
方法：本研究是一项随机对照试验，有两个糖尿病组（一个作为干预组，一个作为对照组）和一个非糖尿病干预组。通过Emed®压力测量平台（NovelGmbH，慕尼黑）在6周之前和之后。在此期间，要求糖尿病和非糖尿病干预组穿着不稳定的鞋子结构（Masai赤脚技术，MBT®)每天至少四个小时。
结果：非糖尿病干预组的结果显示前足内侧部分的接触时间明显较晚，导致更短的接触时间。在脚的内侧下峰值压力也降低,而在脚的外侧下峰值压力增加。糖尿病干预组的变化遵循相同的模式，而糖尿病对照组的值偏离参考值。
结论：鞋结构不稳定的6周感觉运动训练期可以改变非糖尿病受试者和最濒危地区的糖尿病患者的赤脚峰值压力和接触时间，即前足内侧。
方法：本研究是一项随机对照试验，有两个糖尿病组（一个作为干预组，一个作为对照组）和一个非糖尿病干预组。通过Emed®压力测量平台（NovelGmbH，慕尼黑）在6周之前和之后。在此期间，要求糖尿病和非糖尿病干预组穿着不稳定的鞋子结构（Masai赤脚技术，MBT®)每天至少四个小时。
结果：非糖尿病干预组的结果显示前足内侧部分的接触时间明显较晚，导致更短的接触时间。在脚的内侧下峰值压力也降低,而在脚的外侧下峰值压力增加。糖尿病干预组的变化遵循相同的模式，而糖尿病对照组的值偏离参考值。
结论：鞋结构不稳定的6周感觉运动训练期可以改变非糖尿病受试者和最濒危地区的糖尿病患者的赤脚峰值压力和接触时间，即前足内侧。
