Article

The purpose of our study was to examine dynamic foot function during gait as it
relates to plantar loading in individuals with DM (diabetes mellitus and
neuropathy) compared to matched control subjects.
Foot mobility during gait was
examined using a multi-segment kinematic model, and plantar loading was measured
using a pedobarograph in subjects with DM (N = 15), control subjects (N = 15).
Pearson product moment correlation was used to assess the relationship between
variables of interest. Statistical significance and equality of correlations were
assessed using approximate tests based on Fisher's Z transformation (alpha =
0.05). In individuals with DM, first metatarsal sagittal plane excursion during
gait was negatively associated with pressure time integral under the medial
forefoot (r = -0.42 and -0.06, DM and Ctrl, P = 0.02). Similarly, lateral
forefoot sagittal plane excursion during gait was negatively associated with
pressure time integral under the lateral forefoot (r = -0.56 and -0.11, DM and
Ctrl, P = 0.02). Frontal plane excursion of the calcaneus was negatively
associated with medial (r = -0.57 and 0.12, DM and Ctrl, P < 0.01) and lateral (r
= -0.51 and 0.13, DM and Ctrl, P < 0.01) heel and medial forefoot pressure time
integral (r = -0.56 and -0.02, DM and Ctrl, P < 0.01). The key findings of our
study indicate that reductions in segmental foot mobility were accompanied by
increases in local loading in subjects with DM. Reduction in frontal plane
calcaneal mobility during walking serves as an important functional marker of loss of foot flexibility in subjects with DM.
CI - Copyright 2009 Elsevier B.V. All rights reserved.

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