Recherche clinique sur le pied et la cheville

Abstrait

Indicators of Future Ulceration in Diabetes Patients of Low-Moderate Foot Risk

Davida Louise O’Brien, Claire M. Buckley, Frank Hill, Maria Horgan, Ivan J. Perry and Magdalena Tyndyk

Background & Aim: Diabetes Mellitus can cause serious health problems including foot complications. Peripheral neuropathy affects the outer appendages, most commonly the lower limbs. Ulceration of the feet has a high possibility of advancement to amputation; thus greatly diminishing quality of life. This study investigates if patients with diabetes, who are at low-moderate risk of foot disease, have any underlying biomechanical signs which may indicate that they are at risk of future ulceration.

Methods: Twenty patients with Diabetes Mellitus at low-moderate risk of foot disease and 32 healthy individuals participated in this study. All participants completed a self-administrated questionnaire (assessing sociodemographic and lifestyle factors) and underwent a clinical foot screening examination (plantar sensation, pedal pulses and ankle range of motion), gait assessment (spatio-temporal parameters) and barefoot plantar pressure analysis. Results between the 2 groups were compared.

Results: Major differences were observed in area of plantar pressure distribution, walking speed and foot alignment between low-moderate risk participants with diabetes and healthy controls. Low-moderate risk participants with diabetes recorded elevated dynamic plantar pressure in regions of metatarsal heads and the heel. Plantar pressure was correlated with arch type and foot alignment (p<0.05). Dissimilarities were not observed for lifestyle behavior and ankle range of motion.

Conclusion: This pilot study demonstrated a group of patients with diabetes at low-moderate risk of foot disease showing significant differences in biomechanical measures that are linked to callus/ulcer formation. Risk factors for ulceration previously reported for high risk patients with diabetes also affect patients with low-moderate foot risk.