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Abnormalities Of The Foot Loading Pattern Are Present In Patients With Mild Neuropathy
Author(s) -
Caselli A,
Giacomnozzi C,
Macellari V,
Latini V,
Menzinger G,
Uccioli L
Publication year - 2000
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1046/j.1529-8027.2000abstracts-60.x
Subject(s) - foot (prosody) , physical medicine and rehabilitation , medicine , physical therapy , art , literature
Specific alterations of the foot loading pattern have been described in patients with severe diabetic neuropathy, however, some of these might be already present in the earliest stages of peripheral neuropathy. Aim: The aim of our study was to describe the loading pattern in diabetic patients without signs or symptoms of peripheral neuropathy (D), and with mild (DM) and moderate‐severe (DS) neuropathy, classified acording to the Neuropathy Disability Score (NDS), respect to controls (C). Materials and methods: We studied 20 D, 30 DM, 32 DS, age and duration of disease matched, respect to 36 C patients using a piezo‐dynamometric platform that is able to detect the three components of the Ground Reaction Force (GRF) under selected foot sub‐areas, namely heel, metatarsal and hallux. Results: DM and DS showed a significant reduction of the vertical (Fz), the anteroposterior (Fx) and the mediolateral (Fy) components of GRF under the hallux respect to C and D. At the metatarsal sub‐area the peak value of Fz was not significantly different among the four groups of patients, however DS showed an increase of the loading time in this area, expressed by a significantly higher Fz integral (C 2956 ± 430.5, D 3025 ± 521.9, DM 3332 ± 440.3, DS 3525 ± 695.3*§ N.msec). At the heel, only DS showed a reduction of the load. No significant differences were observed between C and D. Conclusions: Diabetic patients with mild neuropathy show specific changes in the loading pattern, mainly at the hallux area. Further changes are recorded at the heel and metatarsal only in patients with moderate‐severe neuropathy and might justify the increased risk of foot ulceration in this group of patients.