Quantitative assessment of foot sensitivity [Elektronische Ressource] : the effects of foot sole skin temperature, blood flow at the foot area and footwear / Günther Schlee

Günther Schlee

Sujets

• Soziologie
• Gesundheit

Informations

• Publié par: technische_universitat_chemnitz
• Publié le: 01 janvier 2010
• Nombre de lectures: 17
• Langue: English

Extrait

Günther Schlee


Quantitative assessment of foot sensitivity: The
effects of foot sole skin temperature, blood flow at
the foot area and footwear


D o c t o r a l T h e s i s

Submitted to Faculty of Behavioral and Social Sciences of the Chemnitz
University of Technology,
to fulfill the requirements
for the degree of
doctor rerum naturalium (Dr. rer. nat.)





April 2010

Günther Schlee


Der Einfluss der Temperatur der Fußsohle, des
Blutflusses im Fußbereich und des Schuhwerks
auf die plantare Fußsensibilität


D i s s e r t a t i o n

zur Erlangung des akademischen Grades
doctor rerum naturalium (Dr. rer. nat.)

vorgelegt der Fakultät für Human und Sozial Wissenschaften der
Technischen Universität Chemnitz





April 2010

















Datum des Promotionskolloquiums: 30/08/2010
Vorsitzender des Promotionskolloquiums: Prof. Dr. Udo Rudolph


Erstgutachter: Prof. Dr. Thomas L. Milani
Zweitgutachter: Prof. Dr. Wilfried Alt





“Following our instincts, not a trend”
James Hetfield

I could not leave the opportunity to acknowledge a few people, who were fundamental during
the process of completing this work.

First and foremost, I would like to thank Thomas for providing me with the opportunity to
come to Germany, for his advices and well as his patience during all these years, both in
professional and personal manners. It’s been definitely an experience for live, thank you very
much!

I would also like to thank all my friends and colleagues, who have helped me to quickly
become “a German guy”. I’m not going to name you all, otherwise I will not have enough
space to thank other people, but you know who you are! However, I would like to especially
acknowledge Thorsten, for all his support and help to push this work further.

A very special, loving thank you goes to my family and all my Brazilian friends, who have
visited me in Germany over all this years and brought a taste of home every now and then. I
would like to especially thank, of course, my mother, who has made everything it was
humanly possible to provide us with the wonderful opportunities we’ve had.

Life in Germany has been really good to me. So good, that I even met my future wife!
Kathrin, thank you. Thank you for your love and comprehension, for your words and
determination. They all inspire me to try and get better. Thank you a lot for your patience, I
know dealing with me is not easy sometimes.

O meu útimo obrigado, e nao por isso o menos importante, vai para Deus e o meu Hepteto
Sagrado. Vocês sabem o por quê.



List of contents


List of contents

List of figures ........................................................................................................................ ii
List of tables ........................................................................................................................ iii
List of Abbreviations ............................................................................................................ iv
Abstract ................................................................................................................................1
Zusammenfassung...............................................................................................................3
Structure of the document ....................................................................................................5
Session 1.................................................................................................................................6
1.1 Rationale ........................................................................................................................6
1.2 Literature ......................................................................................................................10
1.2.1 Perception of mechanical stimuli...........................................................................10
1.2.2 Mechanoreceptors in the foot skin.........................................................................11
1.2.2.1 Adaptation properties of mechanoreceptors...................................................13
1.2.2.2 Distribution of mechanoreceptors in the foot sole ..........................................14
1.2.2.3 Functional structure of Meissner corpuscles ..................................................17
1.2.2.4 Functional structure of Vater-Pacini corpuscles .............................................18
1.2.2.5 Transmission of afferent stimuli......................................................................20
1.2.3 Clinical application of sensory measurements ......................................................21
1.2.3.1 Foot vibration sensitivity and skin temperature ..............................................23
1.2.3.2 Footnsitivity and blood flow .........................................................25
1.2.3.3 Foot vibration sensitivity and footwear ...........................................................26
1.2.3.4 Footnsitivity and gender ..............................................................28
1.2.3.5 Foot vibration sensitivity and plantar foot anatomical location .......................29
1.2.4 Sensorimotor Integration .......................................................................................29
1.3 Definition of the studies/hypotheses.............................................................................32
Session 2...............................................................................................................................33
2.1 Study 1: Foot sole skin temperature affects plantar foot sensitivity..............................33
2.2 Study 2: Short-time lower leg ischemia reduces plantar foot sensitivity.......................45
2.3 Study 3: Effects of footwear on plantar foot sensitivity: a study with Formula 1 shoes 57
Session 3.........70
3.1 Discussion ....................................................................................................................70
3.1.1 Summary of the hypothesis/results of the single studies.......................................70
3.1.2 Combined discussion of the results.......................................................................71
3.1.2 Conclusion and future perspectives ......................................................................76
3.2 References (not listed in the articles) ...........................................................................78
iList of figures


List of figures

Fig. 1.1 Mechanoreceptors and their location in the skin.......................................................12
Fig. 1.2 Response patterns of the cutaneous mechanoreceptors to skin deformation ..........13
Fig. 1.3 Distribution and density of the Meissner corpuscles (MK) in the foot sole. ...............15
Fig. 1.4 Distdensity of the Vater-Pacini corpuscles (PK) in the foot sole............16
Fig. 1.5 Functional structure of a Meissner corpuscle............................................................17
Fig. 1.6 Structural components of a Vater-Pacini corpuscle ..................................................19
Fig. 1.7 Posterior column-medial lemniscus pathway21
Fig. 1.8 Vibration exciter used to quantify plantar foot vibration sensitivity ............................22
Fig. 1.9 Running shoe and its features...................................................................................26
Fig. 1.10 Subjective ratings for Formula 1 drivers..................................................................27
Fig. 2.1 Vibration thresholds (µm): Baseline vs. cooled measurements ................................39
Fig. 2.2 Vibrolds (µm): Baseline vs. warmed measurements ..............................39
Fig. 2.3 Vibration thresholds at the analysed anatomical locations........................................50
Fig. 2.4 Vibrolds in the analysed pressure conditions. ........................................50
Fig. 2.5 Shoe conditions.........................................................................................................60
Fig. 2.6 Vibration thresholds: Barefoot vs. Shod. Values are means of all anatomical
locations. Shod values are means of the four shoe conditions ..............................................63
Fig. 2.7 Vibration thresholds: frequency comparison. Values are means of all anatomical
locations .................................................................................................................................63
Fig. 2.8 Vibration thresholds at 30 Hz. Shod values are means of the four shoe conditions .64
Fig. 2.9 Vibrolds at 200 Hz. Shod values are means of the four shoe conditions64
Fig. 3.1 Combination of individual factors and their influence on foot sensitivity ...................71
Fig. 3.2 Inovative therapeutic footwear for Diabetes patients ................................................76