اثر تغییرات شیب گوه‌ داخلی و خارجی پاشنه بر پارامترهای مکانیکی پا در حین راه رفتن بیماران دیابتی با زخم پا

Objective: there are still disputes over the effect of using slope strategy on the reduction of peak pressure and time of pressure on the foot. Therefore, the objective of this study was to evaluate the effect of internal and external wedge slope changes on the mechanical parameters of foot ulcers. Methods: In this quasi-experimental study 15 diabetic patients with an average age of 63.3±2.01 was selected. 3, 6, 9 and 11 degree wedges were placed in lateral and medial positions in the heel of the patients. Patients wearing the wedge walked over a barometer. For each condition, the data for 3 separate effects were recorded and the mean score for the tries were used for the repeated measure of variance. Results: Compared with the control condition (bare feet), each lateral heel wedge significantly reduced peak pressure on 3rd, 4th and 5th metatarsal head (p=0.01), but, significantly increased peak pressure on the first and second metatarsal head (p=0.01). Each medial heel wedge significantly reduced peak pressure on the first and second metatarsal head (p=0.01), but, significantly increased peak pressure on 3rd, 4th and 5th metatarsal head (p=0.01). The peak of time pressure showed a significant increase at the 3rd, 4th and 5th Metatarsal head area in the 3º lateral heel wedges, and in the 9 and 11 degree medial heel wedges. Moreover, the peak pressure time on the first and second metatarsal heads significantly increased with the 9 and 11 degree lateral and 11 degrees medial heel wedges (p=0.01). Conclusion: The findings indicate that heel wedges can affect the metatarsal head regions differently between the peak pressure and peak pressure time. A median slope of 6 degrees can also be suitable for reducing the peak pressure in the third, forth, and fifth metatarsal heads, while a 6 degree can also be suitable for reducing the peak pressure in the metatarsal head.