Limited Joint Mobility May Play a Role in Diabetic Foot Ulcers

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Limited Joint Mobility May Play a Role in Diabetic Foot Ulcers

NEW YORK (Reuters Health) Apr 06 - In diabetic patients with neuropathy,

limited joint mobility may contribute to the development of foot ulcers,

according to a report in the April issue of Diabetes Care.

In a cross-sectional study, Dr. Stefan Zimny, of Evangelisches Krankenhaus

Bethesda, Duisburg, Germany, and colleagues evaluated the role of limited

joint mobility in causing high plantar pressures in the forefoot of

diabetics with an at-risk foot. Included were 35 at-risk diabetic patients

with foot neuropathy, 35 diabetic controls without neuropathy, and 30

nondiabetic controls.

The researchers assessed joint mobility at the ankle and metatarsophalangeal

joints, using the FastScan plantar pressure analyzer to measure the

pressure-time integrals as dynamic variables in each foot. Standard measures

of peripheral neuropathy were also assessed.

Compared with the diabetic and nondiabetic controls, patients in the at-risk

group had significantly reduced mobility at the ankle and the first

metatarsophalangeal joints (p < 0.0001). In addition, the pressure-time

integrals were significantly higher in this group compared with the other

two groups (p < 0.0001).

" The vibration perception threshold was positively correlated with the

pressure-time integrals in both feet of the diabetic patients, " the

researcher report.

Based on these findings, Dr. Zimny's group concludes that measuring joint

mobility is " a simple and rather exact test to identify diabetic patients

with an at-risk foot. "

" The method is simpler and less costly than measuring the plantar pressuring

loading of the foot itself, " they add, " and might therefore be useful as a

screening tool. "

Diabetes Care 2004;27:942-946.