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Tashiro S, Gotou N, Oku Y, Sugano T, Nakamura T, Suzuki H, Otomo N, Yamada S, Tsuji T, Asato Y, Ishii N. Relationship between Plantar Pressure and Sensory Disturbance in Patients with Hansen's Disease-Preliminary Research and Review of the Literature. SENSORS 2020; 20:s20236976. [PMID: 33291332 PMCID: PMC7730212 DOI: 10.3390/s20236976] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/23/2020] [Accepted: 12/04/2020] [Indexed: 12/18/2022]
Abstract
Orthoses and insoles are among the primary treatments and prevention methods of refractory plantar ulcers in patients with Hansen’s disease. While dynamic plantar pressure and tactile sensory disturbance are the critical pathological factors, few studies have investigated whether a relationship exists between these two factors. In this study, dynamic pressure measured using F-scan system and tactile sensory threshold evaluated with monofilament testing were determined for 12 areas of 20 feet in patients with chronic Hansen’s disease. The correlation between these two factors was calculated for each foot, for each clinical category of the foot (0–IV) and across all feet. A significant correlation was found between dynamic pressure and tactile sensation in Category II feet (n = 8, p = 0.016, r2 = 0.246, Spearman’s rank test). In contrast, no significant correlation was detected for the entire foot or within the subgroups for the remainder of the clinical categories. However, the clinical manifestation of lesion areas showed high variability: (1) pressure concentrated, sensation lost; (2) margin of pressure concentration, sensation lost; (3) pressure concentrated, sensation severely disturbed but not lost; and (4) tip of the toe. These results may indicate that, even though there was a weak relationship between dynamic pressure and tactile sensation, it is important to assess both, in addition to the basics of orthotic treatment in patients with Hansen’s disease presenting with refractory plantar ulceration.
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Affiliation(s)
- Syoichi Tashiro
- Department of Rehabilitation, National Sanatorium Tamazenshoen, Higashi-Murayama, Tokyo 189-0002, Japan; (Y.O.); (T.N.); (H.S.)
- Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan;
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan;
- Correspondence: ; Tel.: +81-3-5363-3833
| | - Naoki Gotou
- Department of Prosthesis and Orthosis, National Sanatorium Tamazenshoen, Higashi-Murayama, Tokyo 189-0002, Japan; (N.G.); (T.S.)
| | - Yuki Oku
- Department of Rehabilitation, National Sanatorium Tamazenshoen, Higashi-Murayama, Tokyo 189-0002, Japan; (Y.O.); (T.N.); (H.S.)
- Department of Rehabilitation, National Hospital Organization Tokyo Hospital, Kiyose, Tokyo 204-8585, Japan
| | - Takahiro Sugano
- Department of Prosthesis and Orthosis, National Sanatorium Tamazenshoen, Higashi-Murayama, Tokyo 189-0002, Japan; (N.G.); (T.S.)
| | - Takuya Nakamura
- Department of Rehabilitation, National Sanatorium Tamazenshoen, Higashi-Murayama, Tokyo 189-0002, Japan; (Y.O.); (T.N.); (H.S.)
- Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan;
| | - Hiromi Suzuki
- Department of Rehabilitation, National Sanatorium Tamazenshoen, Higashi-Murayama, Tokyo 189-0002, Japan; (Y.O.); (T.N.); (H.S.)
| | - Nao Otomo
- Department of Orthopaedic Surgery, National Sanatorium Tamazenshoen, Higashi-Murayama, Tokyo 189-0002, Japan;
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan
| | - Shin Yamada
- Department of Rehabilitation Medicine, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan;
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo 160-8582, Japan;
| | - Yutaka Asato
- Department of Surgery, National Sanatorium Tamazenshoen, Higashi-Murayama, Tokyo 189-0002, Japan;
| | - Norihisa Ishii
- Department of Dermatology, National Sanatorium Tamazenshoen, Higashi-Murayama, Tokyo 189-0002, Japan;
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