糖尿病性末梢神経障害に伴う足底最大庄の変化についての検討

Diabetic peripheral neuropathy (DPN) is associated with progressive loss of sensation, restriction of lower limb joint range of motion, and gait alternation. These impairments are significant risk for diabetic plantar ulcer. The aim of the present study is to evaluate the relationship between neuropathy and plantar pressure profilel in diabetic patients with different degrees of peripheral neuropathy. Twenty-four patients of type2 diabetes with DPN were enrolled and classified into 3 groups according to DPN severity, and simultaneously estimated sensory and motor nerve conduction velocity (SCV, MCV), toe and ankle joint range of motion, and peak plantar pressure. Plantar area was divided into 4 regions: toe, forefoot, midfoot and rearfoot. To prevent the extreme variation, patients with plantar callus were excluded. SCV, MCV, toe and ankle joint range of motion, and peak plantar pressure of toe and forefoot were correlated with DPN severity, Moreover, the peak pressure ratio of toe to forefoot was significantly increased in proportion to DPN severity and the restriction of toe joint range of motion. These results indicate that except patients with plantar callus. increasing degrees of DPN restricts the toe joint flexibility and the relative peak plantar pressure of toe rises in accordance with DPN severity.