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Article

Factors Associated with Callus Formation in the Plantar Region through Gait Measurement in Patients with Diabetic Neuropathy: An Observational Case-Control Study

1
Department of Nursing Physiology, Graduate School of Nursing, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8672, Japan
2
Department of Smart Sensing Technology, Electrical and Information Engineering, Faculty of Engineering, Osaka City University, 3-3-138 Sugimoto Sumiyoshi-ku, Osaka 558-8585, Japan
3
Department of Clinical Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa 920-0942, Japan
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Department of Nursing, Graduate School of Medicine, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya City, Aichi 461-8673, Japan
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Department of Nursing, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Department of Diabetes Endocrinology and Metabolism, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
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Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
9
Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
10
Next Generation Artificial Intelligence Research Center, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
*
Author to whom correspondence should be addressed.
Sensors 2020, 20(17), 4863; https://doi.org/10.3390/s20174863
Received: 11 August 2020 / Revised: 22 August 2020 / Accepted: 25 August 2020 / Published: 28 August 2020
(This article belongs to the Special Issue Wearable Inertial Sensors)
Callus has been identified as a risk factor leading to severe diabetic foot ulcer; thus, it is necessary to prevent its formation. Callus formation under the first, second, and fifth metatarsal heads (MTHs) is associated with external forces (pressure and shear stress) during walking. However, the gait factors increasing the external forces remain undetermined. Thus, this study aims to identify the factors increasing the external forces to prevent callus formation. In 59 patients with diabetic neuropathy wearing their usual shoes, the external forces, and the lower extremity joint angles were measured using MEMS force sensors and motion sensors. The external forces and their relationship with the lower extremity joint angles and footwear size were determined. Risk factors causing high external forces on the first MTH included small flexion of the knee joint (p = 0.015) and large ankle pronation motion (p = 0.034) to obtain propulsion. For the second MTH, wearing excessively long footwear was identified (p = 0.026). For the fifth MTH, high external force was related to tight width footwear (p = 0.005). An effective intervention for preventing callus formation for the first MTH would involve assisting the push-off foot motion using rocker-sole footwear or gait training. For the second and fifth MTHs, wearing appropriate size footwear would be effective. View Full-Text
Keywords: diabetic foot; diabetic neuropathies; foot; footwear characteristics; lower extremity joint angles; shear stress; shoes; pressure; prevention of callus formation; walking diabetic foot; diabetic neuropathies; foot; footwear characteristics; lower extremity joint angles; shear stress; shoes; pressure; prevention of callus formation; walking
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MDPI and ACS Style

Amemiya, A.; Noguchi, H.; Oe, M.; Takehara, K.; Ohashi, Y.; Suzuki, R.; Yamauchi, T.; Kadowaki, T.; Sanada, H.; Mori, T. Factors Associated with Callus Formation in the Plantar Region through Gait Measurement in Patients with Diabetic Neuropathy: An Observational Case-Control Study. Sensors 2020, 20, 4863. https://doi.org/10.3390/s20174863

AMA Style

Amemiya A, Noguchi H, Oe M, Takehara K, Ohashi Y, Suzuki R, Yamauchi T, Kadowaki T, Sanada H, Mori T. Factors Associated with Callus Formation in the Plantar Region through Gait Measurement in Patients with Diabetic Neuropathy: An Observational Case-Control Study. Sensors. 2020; 20(17):4863. https://doi.org/10.3390/s20174863

Chicago/Turabian Style

Amemiya, Ayumi, Hiroshi Noguchi, Makoto Oe, Kimie Takehara, Yumiko Ohashi, Ryo Suzuki, Toshimasa Yamauchi, Takashi Kadowaki, Hiromi Sanada, and Taketoshi Mori. 2020. "Factors Associated with Callus Formation in the Plantar Region through Gait Measurement in Patients with Diabetic Neuropathy: An Observational Case-Control Study" Sensors 20, no. 17: 4863. https://doi.org/10.3390/s20174863

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