2023 Fiscal Year Final Research Report

Development of a gait support program by deep learning for recurrence risk of diabetic foot ulcers

Research Project

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Project/Area Number	19K12915
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 90150:Medical assistive technology-related
Research Institution	Aichi Shukutoku University (2021-2023) Seijoh University (2019-2020)
Principal Investigator	Hayashi Hisae 愛知淑徳大学, 健康医療科学部, 教授 (80444404)
Co-Investigator(Kenkyū-buntansha)	河野健一国際医療福祉大学, 成田保健医療学部, 准教授 (10638480) 岩本哲哉国立保健医療科学院, その他部局等, 主任研究官 (40782412) 小池孝康岐阜保健大学短期大学部, その他部局等, 助教 (10720253)
Project Period (FY)	2019-04-01 – 2024-03-31
Keywords	糖尿病足病変 / 深層学習 / CLTI / LEAD / 透析患者 / 活動量 / 足圧中心軌跡
Outline of Final Research Achievements	Diabetic foot ulcers have a high recurrence rate and can lead to gait impairments, making the establishment of preventive measures against recurrence crucial. This multicenter collaborative study investigated the risk of foot ulcer recurrence by analyzing the plantar pressure distribution during gait. The impact of comorbidities on recurrence was clarified, demonstrating the importance of managing lower extremity arterial disease and adjusting load-bearing areas during gait. Based on the findings, a support tool was devised to visually present the necessary precautions for daily activities and gait by answering questions about treatment history and ambulatory status. Following the development of this tool, gait practice methods were also examined. This sub-study demonstrated the utility of somatosensory feedback when verbal instructions proved inadequate in correcting the distribution of load-bearing areas during gait, provided there are no severe peripheral neuropathies.
Free Research Field	リハビリテーション
Academic Significance and Societal Importance of the Research Achievements	足趾切断や足潰瘍治療後の歩行時の足圧分布は、個別性が高いため解析が困難であったが、深層学習により糖尿病足病変再発リスクに関与する足圧軌跡の特徴を確認できたことは学術的意義が高いと考える。また再発に影響をおよぼす要因として、併存疾患の影響が大きいことを確認できた点は、歩行支援を進めるうえで重要な所見である。これらの結果に基づき、下肢動脈治療後の生活動作や足病変再発予防に向けた歩行時の注意点を示す支援ツールを作製し公開した。この支援ツールが治療を受けた方や医療従事者に活用されれば、糖尿病足病変の再発予防への寄与が期待できるため、社会的意義があると考える。