Gait parameters of people with diabetes-related neuropathic plantar foot ulcers

Article


Fernando, Malindu Eranga, Crowther, Robert G., Lazzarini, Peter A., Sangla, Kunwarjit S., Buttner, Petra and Golledge, Jonathan. 2016. "Gait parameters of people with diabetes-related neuropathic plantar foot ulcers." Clinical Biomechanics. 37, pp. 98-107. https://doi.org/10.1016/j.clinbiomech.2016.06.006
Article Title

Gait parameters of people with diabetes-related neuropathic plantar foot ulcers

ERA Journal ID9746
Article CategoryArticle
AuthorsFernando, Malindu Eranga (Author), Crowther, Robert G. (Author), Lazzarini, Peter A. (Author), Sangla, Kunwarjit S. (Author), Buttner, Petra (Author) and Golledge, Jonathan (Author)
Journal TitleClinical Biomechanics
Journal Citation37, pp. 98-107
Number of Pages9
Year2016
Place of PublicationUnited Kingdom
ISSN0268-0033
1879-1271
Digital Object Identifier (DOI)https://doi.org/10.1016/j.clinbiomech.2016.06.006
Web Address (URL)http://www.sciencedirect.com/science/article/pii/S026800331630095X
Abstract

Background: Foot ulceration associated with diabetic peripheral neuropathy is a global concern. Biomechanical investigation allows the identification of gait abnormalities that may adversely affect ulcer healing. The objective of this case–control study was to compare the gait parameters of cases with diabetes-related foot ulcers to controls.

Methods: Three-dimensional movement analyses were performed on 21 people with diabetes-related neuropathic plantar foot ulcers (cases), 69 people with diabetes without a foot ulcer history (diabetes controls) and 56 healthy controls. Outcome data were reported as mean differences, 95% confidence intervals and Cohen's d effect sizes. Binary logistic regressions were used to adjust for age, sex and body mass index.

Findings: People with foot ulcers had a smaller plantar flexion (Cohen's d = − 0.6 vs. diabetes controls and d = − 0.8 vs. healthy controls), knee flexion (d = − 0.6 vs. diabetes controls and d = − 1.0 vs. healthy controls) and pelvic obliquity (d = − 0.9 vs. diabetes controls and d = − 0.7 vs. healthy controls) (all P < 0.05). They also had a significantly greater range of anterior–posterior ground reaction force (d = 1.0 vs. diabetes controls and d = 1.7 vs. healthy controls) and total vertical ground reaction force (d = 0.9 vs. diabetes controls and d = 1.1 vs. healthy controls) and significantly slower walking speed and smaller step length compared to controls (all P < 0.05).

Interpretation: People with plantar foot ulcers have considerably different gait parameters to controls. Whether the observed gait parameters contributed to the ulcer development or are a response to the ulcer is currently unclear and needs further investigation.

Keywordsdiabetic foot disease; biomechanics; plantar ulcers; peripheral diabetic neuropathy; foot ulceration; gait
ANZSRC Field of Research 2020420701. Biomechanics
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Byline AffiliationsJames Cook University
Queensland University of Technology
Department of Health, Queensland
Institution of OriginUniversity of Southern Queensland
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