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

Fernando, Malindu Eranga and Crowther, Robert G. and Lazzarini, Peter A. and Sangla, Kunwarjit S. and Buttner, Petra and Golledge, Jonathan (2016) Gait parameters of people with diabetes-related neuropathic plantar foot ulcers. Clinical Biomechanics, 37. pp. 98-107. ISSN 0268-0033


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.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Files associated with this item cannot be displayed due to copyright restrictions.
Faculty / Department / School: Current - Faculty of Health, Engineering and Sciences - School of Health and Wellbeing
Date Deposited: 22 Jul 2016 01:49
Last Modified: 22 Jul 2016 01:49
Uncontrolled Keywords: diabetic foot disease; biomechanics; plantar ulcers; peripheral diabetic neuropathy; foot ulceration; gait
Fields of Research : 11 Medical and Health Sciences > 1106 Human Movement and Sports Science > 110601 Biomechanics
Socio-Economic Objective: C Society > 92 Health > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes
Identification Number or DOI: 10.1016/j.clinbiomech.2016.06.006

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