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Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy
BACKGROUND: Patients with diabetic polyneuropathy (DPN) are often confronted with ulceration of foot soles. Increased plantar pressure under the forefoot has been identified as a major risk factor for ulceration. This study sets out to test the hypothesis that changes in gait characteristics induced...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2009
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654541/ https://www.ncbi.nlm.nih.gov/pubmed/19192272 http://dx.doi.org/10.1186/1471-2474-10-16 |
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author | Savelberg, Hans HCM Schaper, Nicolaas C Willems, Paul JB de Lange, Ton LH Meijer, Kenneth |
author_facet | Savelberg, Hans HCM Schaper, Nicolaas C Willems, Paul JB de Lange, Ton LH Meijer, Kenneth |
author_sort | Savelberg, Hans HCM |
collection | PubMed |
description | BACKGROUND: Patients with diabetic polyneuropathy (DPN) are often confronted with ulceration of foot soles. Increased plantar pressure under the forefoot has been identified as a major risk factor for ulceration. This study sets out to test the hypothesis that changes in gait characteristics induced by DPN related muscle weakness are the origin of the elevated plantar pressures. METHODS: Three groups of subjects participated: people diagnosed with diabetes without polyneuropathy (DC), people diagnosed with diabetic polyneuropathy (DPN) and healthy, age-matched controls (HC). In all subjects isometric strength of plantar and dorsal flexors was assessed. Moreover, joint moments at ankle, knee and hip joints were determined while walking barefoot at a velocity of 1.4 m/s. Simultaneously plantar pressure patterns were measured. RESULTS: Compared to HC-subjects, DPN-participants walked with a significantly increased internal plantar flexor moment at the first half of the stance phase. Also in DPN-subjects the maximal braking and propelling force applied to the floor was decreased. Moreover, in DPN-subjects the ratio of forefoot-to-rear foot plantar pressures was increased. Body-mass normalized strength of dorsal flexors showed a trend to be reduced in people with diabetes, both DC and DPN, compared to HC-subjects. Plantar flexors tended to be less weak in DC compared to HC and in DPN relative to DC. CONCLUSION: The results of this study suggest that adverse plantar pressure patterns are associated with redistribution of joint moments, and a consequent reduced capacity to control forward velocity at heel strike. |
format | Text |
id | pubmed-2654541 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2009 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-26545412009-03-13 Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy Savelberg, Hans HCM Schaper, Nicolaas C Willems, Paul JB de Lange, Ton LH Meijer, Kenneth BMC Musculoskelet Disord Research Article BACKGROUND: Patients with diabetic polyneuropathy (DPN) are often confronted with ulceration of foot soles. Increased plantar pressure under the forefoot has been identified as a major risk factor for ulceration. This study sets out to test the hypothesis that changes in gait characteristics induced by DPN related muscle weakness are the origin of the elevated plantar pressures. METHODS: Three groups of subjects participated: people diagnosed with diabetes without polyneuropathy (DC), people diagnosed with diabetic polyneuropathy (DPN) and healthy, age-matched controls (HC). In all subjects isometric strength of plantar and dorsal flexors was assessed. Moreover, joint moments at ankle, knee and hip joints were determined while walking barefoot at a velocity of 1.4 m/s. Simultaneously plantar pressure patterns were measured. RESULTS: Compared to HC-subjects, DPN-participants walked with a significantly increased internal plantar flexor moment at the first half of the stance phase. Also in DPN-subjects the maximal braking and propelling force applied to the floor was decreased. Moreover, in DPN-subjects the ratio of forefoot-to-rear foot plantar pressures was increased. Body-mass normalized strength of dorsal flexors showed a trend to be reduced in people with diabetes, both DC and DPN, compared to HC-subjects. Plantar flexors tended to be less weak in DC compared to HC and in DPN relative to DC. CONCLUSION: The results of this study suggest that adverse plantar pressure patterns are associated with redistribution of joint moments, and a consequent reduced capacity to control forward velocity at heel strike. BioMed Central 2009-02-03 /pmc/articles/PMC2654541/ /pubmed/19192272 http://dx.doi.org/10.1186/1471-2474-10-16 Text en Copyright © 2009 Savelberg et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Savelberg, Hans HCM Schaper, Nicolaas C Willems, Paul JB de Lange, Ton LH Meijer, Kenneth Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy |
title | Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy |
title_full | Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy |
title_fullStr | Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy |
title_full_unstemmed | Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy |
title_short | Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy |
title_sort | redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654541/ https://www.ncbi.nlm.nih.gov/pubmed/19192272 http://dx.doi.org/10.1186/1471-2474-10-16 |
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