Development of non-invasive approach utilizing physical therapies for the prevention of foot ulceration in diabetic patients

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K11538
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Plastic surgery
• Research Institution: Kobe University
• Principal Investigator: Fujii Miki 神戸大学, 医学研究科, 医学研究員 (80444602)
• Co-Investigator(Kenkyū-buntansha): 寺師 浩人 神戸大学, 医学部附属病院, 教授 (80217421) ; 前重 伯壮 神戸大学, 保健学研究科, 助教 (90617838)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 糖尿病性足病変 / 足底圧 / 理学療法 / ストレッチング / 下腿三頭筋 / 電気刺激療法 / 前脛骨筋

Outline of Final Research Achievements

Abnormal plantar pressure during walking should be managed to prevent foot ulcer developments in diabetic patients. Especially in diabetic patients with peripheral neuropathy, ankle dorsiflexion-range of motion (ROM) during walking has been reported to decrease strongly, resulting in high plantar pressure. The present study demonstrated that continuous stretching in triceps surae and electrical stimulation to tibialis anterior muscle improved the patient's ROM in ankle dorsiflexion and reduced abnormal plantar pressure during walking. As for the kinematic mechanism, the correction in medial deviation of center of pressure led to the suppression in pressure concentration on medial forefoot. These results suggest that the combination therapy of electrical stimulation and stretching is a therapeutic option to prevent the development of foot ulcers via improvement of abnormal gait patterns in diabetic patients.

Free Research Field

形成外科

Academic Significance and Societal Importance of the Research Achievements

これまでは、糖尿病患者の足部の硬さを改善できる保存療法は確立していなかった。本研究では、その硬さ、すなわち足関節背屈角度を改善できるストレッチング方法の工夫点を見出した。そして、その介入方法が、足部の硬さを改善すると同時に、足底の異常な圧迫を軽減することを明らかにした。足部の痛みを感じづらくなる糖尿病患者にとって、足底面の異常な圧迫力を軽減する方法は、潰瘍発生の予防に役立つ。