title: Functional limitations in patients with diabetes and transmetatarsal amputations.
abstract: OBJECTIVE
  Reports in the surgical and rehabilitation literature suggest that patients with transmetatarsal amputations (TMAs) function well with regular shoes and a toe filler. Functional limitations, however, have not been documented in this population. The purpose of this study was to compare the function of patients with diabetes mellitus (DM) and TMA with that of age- and gender-matched control subjects.
  
  
  METHODS
  Thirty subjects (15 subjects with DM and TMAs and 15 control subjects), with a mean age of 62.3 years (SD = 9.2, range = 43-83), were studied.
  
  
  METHODS
  Function was measured using the Functional Reach Test (FRT), the Physical Performance Test (PPT), walking speed for 15.2 m (50 ft), and the Sickness Impact Profile (SIP). Subjects in the TMA-DM group wore standard shoes with a toe filler.
  
  
  RESULTS
  The TMA-DM group scored lower (mean +/- standard deviation) than did the control group on all tests (FRT: 19.1 +/- 8.6 vs 31.5 +/- 9.1 cm [7.5 +/- 3.4 vs 12.4 +/- 3.6 in]; PPT: 18.7 +/- 4.8 vs 24.1 +/- 2.2 points [28 points possible]; walking speed: 51.5 +/- 13.2 vs 75.6 +/- 9.3 m/min; SIP: 17.0 +/- 12.7 vs 3.7 +/- 4.7).
  
  
  CONCLUSIONS
  Persons with DM and TMAs have considerable functional limitations. Research is needed to determine whether therapeutic footwear or other forms of rehabilitation can improve their function.
authors.affiliation: Program of Physical Therapy, Washington University School of Medicine, St Louis, MO 63110, USA. muellerm@medicine.wustl.edu
authors.forename: M J
authors.initials: MJ
authors.lastname: Mueller
authors.forename: G B
authors.initials: GB
authors.lastname: Salsich
authors.forename: M J
authors.initials: MJ
authors.lastname: Strube
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000523:psychology / Q000534:rehabilitation*; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008684:Metatarsus / Q000601:surgery; D008875:Middle Aged; D018434:Sickness Impact Profile