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The Role of Foot-Loading Factors and Their Associations with Ulcer Development and Ulcer Healing in People with Diabetes: A Systematic Review

机译:脚踏因子及其协会在糖尿病患者中的作用及其关联与溃疡患者的作用:系统评价

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We aimed to comprehensively and systematically review studies associating key foot-loading factors (i.e., plantar pressure, weight-bearing activity, adherence or a combination thereof) with ulcer development and ulcer healing in people with diabetes. A systematic literature search was performed in PubMed and EMBASE. We included studies if barefoot or in-shoe plantar pressure, weight-bearing activity or footwear or device adherence was measured and associated with either ulcer development or ulcer healing in people with diabetes. Out of 1954 records, 36 studies were included and qualitatively analyzed. We found low to moderate quality evidence that lower barefoot plantar pressure and higher footwear and device adherence associate with lower risk of ulcer development and shorter healing times. For the other foot-loading factors, we found low quality evidence with limited or contradictory results. For combined measures of foot-loading factors, we found low quality evidence suggesting that lower cumulative plantar tissue stress is associated with lower risk of ulcer development and higher ulcer healing incidence. We conclude that evidence for barefoot plantar pressure and adherence in association with ulcer outcome is present, but is limited for the other foot-loading factors. More comprehensive investigation in particularly the combination of foot-loading factors may improve the evidence and targeting preventative treatment.
机译:我们旨在全面,系统地审查将关键脚踏因子(即,跖骨压力,负荷活性,粘附或其组合)与糖尿病患者的溃疡愈合相关联的研究。在PubMed和Embase中进行了系统文献搜索。我们包括研究,如果赤脚或鞋类跖跖或鞋类或装置粘附,并且与糖尿病人的溃疡发育或溃疡愈合有关。在1954年的记录中,包括36项研究并进行定性分析。我们发现低于适度的质量证据,即赤脚的跖骨压力和更高的鞋类和装置粘附,伴随溃疡发育的风险较低,愈合时间较短。对于其他脚踏装载因子,我们发现具有有限或矛盾的结果的低质量证据。为了综合衡量脚踏因子,我们发现低质量证据表明较低的累积植物组织应激与溃疡发育较低的风险较低,溃疡愈合发病率较高。我们得出结论,存在赤脚跖骨压力和与溃疡结果相关的粘附的证据,但对于其他脚踏因子有限。特别是脚踏因子的组合更全面的调查可以改善证据和靶向预防性治疗。

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