Abstract
While lower limb biomechanics of people with diabetes are well described, the effects of diabetes type and of peripheral neuropathy on foot joint kinematics have not been addressed in depth. A total of 70 patients with type 1 (n = 25) and type 2 (n = 45) diabetes mellitus, with and without peripheral neuropathy, underwent functional evaluation via gait analysis using an established multisegment foot kinematic model. ANCOVA was performed to assess differences in foot joints’ range of motion (ROM) between groups with diabetes and a control group by accounting for the effects of age, body mass index (BMI) and normalized walking speed. Statistical parametric mapping was used to assess differences in temporal patterns of foot joint motion across normalized gait cycle. Small but significant correlations were found between age, BMI, speed and foot joints’ ROM. Regardless of diabetes type and presence of neuropathy, all subgroups with diabetes showed limited ROM at the midtarsal and tarsometatarsal joints. Increased midtarsal joint dorsiflexion and adduction was associated with increased tarsometatarsal joint plantarflexion. After accounting for the effect of covariates, diabetes is associated with reduced ROM and to alterations of the kinematic patterns, especially at the midtarsal and tarsometatarsal joints, irrespective of type and neuropathy.
Highlights
Diabetic foot refers to a complex set of physiological and mechanical alterations affecting the feet of persons with type 1 and type 2 diabetes mellitus [1]
Deeper understanding of multisegment foot kinematics in people with diabetes may help understanding the multiple alterations in foot biomechanics which likely occur at a later stage of the disease, as well as driving early rehabilitation treatments
body mass index (BMI), age and walking speed correlated with foot joints range of motion (ROM) in different populations with diabetes and diabetic peripheral neuropathy (DPN)
Summary
Diabetic foot refers to a complex set of physiological and mechanical alterations affecting the feet of persons with type 1 and type 2 diabetes mellitus [1]. Diabetes is often associated with the presence and severity of diabetic peripheral neuropathy (DPN), a multifactorial chronic complication related to vascular and nerve damage. This leads to progressive loss of vibratory, thermal, tactile and proprioceptive sensitivity [4], mainly distal muscle weakness and dysfunction [5,6,7,8], distal joint motion restrictions [9,10,11,12] and eventually to the development of foot ulcers and amputations [13]. DPN, together with compromised blood flow, is responsible for a high number of ulcerations; up to 60% of lower extremity amputations are due to diabetic foot ulcers [14,15]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
