Lower limb biomechanical characteristics of patients with neuropathic diabetic foot ulcers: the diabetes foot ulcer study protocol

Article


Fernando, Malindu Eranga, Crowther, Robert George, Cunningham, Margaret, Lazzarini, Peter Anthony, Sangla, Kunwarjit Singh and Golledge, Jonathan. 2015. "Lower limb biomechanical characteristics of patients with neuropathic diabetic foot ulcers: the diabetes foot ulcer study protocol." BMC Endocrine Disorders. 15 (59), pp. 1-11. https://doi.org/10.1186/s12902-015-0057-7
Article Title

Lower limb biomechanical characteristics of patients with neuropathic diabetic foot ulcers: the diabetes foot ulcer study protocol

ERA Journal ID40985
Article CategoryArticle
AuthorsFernando, Malindu Eranga (Author), Crowther, Robert George (Author), Cunningham, Margaret (Author), Lazzarini, Peter Anthony (Author), Sangla, Kunwarjit Singh (Author) and Golledge, Jonathan (Author)
Journal TitleBMC Endocrine Disorders
Journal Citation15 (59), pp. 1-11
Number of Pages11
Year2015
Place of PublicationUnited Kingdom
ISSN1472-6823
Digital Object Identifier (DOI)https://doi.org/10.1186/s12902-015-0057-7
Web Address (URL)http://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-015-0057-7
Abstract

Background: Foot ulceration is the main precursor to lower limb amputation in patients with type 2 diabetes worldwide. Biomechanical factors have been implicated in the development of foot ulceration; however the association of these factors to ulcer healing remains less clear. It may be hypothesised that abnormalities in temporal spatial parameters (stride to stride measurements), kinematics (joint movements), kinetics (forces on the lower limb) and plantar pressures (pressure placed on the foot during walking) contribute to foot ulcer healing. The primary aim of this study is to establish the biomechanical characteristics (temporal spatial parameters, kinematics,
kinetics and plantar pressures) of patients with plantar neuropathic foot ulcers compared to controls without a
history of foot ulcers. The secondary aim is to assess the same biomechanical characteristics in patients with foot
ulcers and controls over-time to assess whether these characteristics remain the same or change throughout ulcer
healing.

Methods/Design: The design is a case–control study nested in a six-month longitudinal study. Cases will be participants with active plantar neuropathic foot ulcers (DFU group). Controls will consist of patients with type 2
diabetes (DMC group) and healthy participants (HC group) with no history of foot ulceration. Standardised gait and
plantar pressure protocols will be used to collect biomechanical data at baseline, three and six months. Descriptive variables and primary and secondary outcome variables will be compared between the three groups at baseline and follow-up.

Discussion: It is anticipated that the findings from this longitudinal study will provide important information
regarding the biomechanical characteristic of type 2 diabetes patients with neuropathic foot ulcers. We hypothesise that people with foot ulcers will demonstrate a significantly compromised gait pattern (reduced temporal spatial parameters, kinematics and kinetics) at base line and then throughout the follow-up period compared to controls. The study may provide evidence for the design of gait-retraining, neuro-muscular conditioning and other
approaches to off-load the limbs of those with foot ulcers in order to reduce the mechanical loading on the foot
during gait and promote ulcer healing.

Keywordsdiabetic neuropathies; diabetic foot; foot ulcer; longitudinal studies; gait; protocols; plantar pressure
ANZSRC Field of Research 2020420701. Biomechanics
Byline AffiliationsJames Cook University
University of Stirling, United Kingdom
Queensland University of Technology
Department of Health, Queensland
Institution of OriginUniversity of Southern Queensland
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