Abstract
Diabetes has been one of the most common chronic diseases all over the world. The purpose of this study was to quantitatively assess the foot loading characteristics of diabetic patients with fifth-toe deformity through a comparative analysis with diabetic patients with healthy and normal feet. Six neuropathic diabetic female subjects with the fifth-toe deformation and six age-matched neuropathic diabetic controls without any feet deformities participated in the walking test. Dynamic barefoot plantar pressure was measured with Novel EMED force plate. Peak pressure and pressure-time integral for all 7 foot regions (rearfoot, midfoot, lateral forefoot, central forefoot, medial forefoot, great toe, and other toes) were collected. Peak pressure was significantly higher in the patients with toe deformity in rearfoot, central forefoot, and great toe regions compared with the control group. Meanwhile, loading sustaining period extended longer in great toe region of deformed group than in that of the control group, and the center of pressure was nearly in the big toe region during toe offstage. Diabetic patients with fifth-toe deformity could have plantar contact area reduction in the other toes part and increased loading to the great toe part. The result showed that fifth-toe deformity was associated with potential ulceration risk especially in hallux region.
Highlights
Diabetes mellitus has been one of the most common chronic diseases that influenced people’s normal daily life
The other toes (OT) part of the deformed group showed no contact or plantar pressure in the relevant anatomy part compared with the control group (Figure 2)
Combining the results of quantitative analysis, the peak pressure of the deformed group was basically focused in the great toe (GT) region and significantly higher than that in the control group
Summary
Diabetes mellitus has been one of the most common chronic diseases that influenced people’s normal daily life. Diabetic foot with foot ulceration or foot deformation hinders the normal locomotion [2] It was the result of long-term loading to the foot plantar surface during gait that changed or transferred in particular regions among patients with diabetes mellitus and peripheral neuropathy [2,3,4]. Some excessive pressures in feet that lack protective sensation are considered as a major risk factor for plantar ulceration [3], which is the most common precursor to lower extremity amputation among patients with diabetes [5]. Previous study found that early diabetic foot tends to be toes deformities [7,8,9] and imbalance in the muscles to the foot or lower extremity [10], causing abnormal plantar pressure [11]. When the lesion or dysfunction of the human foot structure and human locomotion ability deteriorated, plantar pressure and foot loading distribution would change [12, 13]
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