title: Effect of viscoelastic properties of plantar soft tissues on plantar pressures at the first metatarsal head in diabetics with peripheral neuropathy.
abstract: Diabetic foot ulcers are one of the most serious complications associated with diabetes mellitus. Current research studies have demonstrated that biomechanical alterations of the diabetic foot contribute to the development of foot ulcers. However, the changes of soft tissue biomechanical properties associated with diabetes and its influences on the development of diabetic foot ulcers have not been investigated. The purpose of this study was to investigate the effect of diabetes on the biomechanical properties of plantar soft tissues and the relationship between biomechanical properties and plantar pressure distributions. We used the ultrasound indentation tests to measure force-deformation relationships of plantar soft tissues and calculate the effective Young's modulus and quasi-linear viscoelastic parameters to quantify biomechanical properties of plantar soft tissues. We also measured plantar pressures to calculate peak plantar pressure and plantar pressure gradient. Our results showed that diabetics had a significantly greater effective Young's modulus and initial modulus of quasi-linear viscoelasticity compared to non-diabetics. The plantar pressure gradient and biomechanical properties were significantly correlated. Our findings indicate that diabetes is linked to an increase in viscoelasticity of plantar soft tissues that may contribute to a higher peak plantar pressure and plantar pressure gradient in the diabetic foot.
authors.affiliation: Rehabilitation Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA. yjan@illinois.edu
authors.forename: Yih-Kuen
authors.initials: YK
authors.lastname: Jan
authors.forename: Chi-Wen
authors.initials: CW
authors.lastname: Lung
authors.forename: Elena
authors.initials: E
authors.lastname: Cuaderes
authors.forename: Daqian
authors.initials: D
authors.lastname: Rong
authors.forename: Kari
authors.initials: K
authors.lastname: Boyce
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D017719:Diabetic Foot / Q000503:physiopathology*; D055119:Elastic Modulus; D005260:Female; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000503:physiopathology*; D017711:Nonlinear Dynamics; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology*; D011312:Pressure; D014783:Viscosity; D055815:Young Adult