title: Comparison of foot segmental mobility and coupling during gait between patients with diabetes mellitus with and without neuropathy and adults without diabetes.
abstract: BACKGROUND
  Reduction in foot mobility has been identified as a key factor of altered foot biomechanics in individuals with diabetes mellitus. This study aimed at comparing in vivo segmental foot kinematics and coupling in patients with diabetes with and without neuropathy to control adults.
  
  
  METHODS
  Foot mobility of 13 diabetic patients with neuropathy, 13 diabetic patients without neuropathy and 13 non-diabetic persons was measured using an integrated measurement set-up including a plantar pressure platform and 3D motion analysis system. In this age-, sex- and walking speed matched comparative study; differences in range of motion quantified with the Rizzoli multisegment foot model throughout different phases of the gait cycle were analysed using one-way repeated measures analysis of variance (ANOVA). Coupling was assessed with cross-correlation techniques.
  
  
  RESULTS
  Both cohorts with diabetes showed significantly lower motion values as compared to the control group. Transverse and sagittal plane motion was predominantly affected with often lower range of motion values found in the group with neuropathy compared to the diabetes group without neuropathy. Most significant changes were observed during propulsion (both diabetic groups) and swing phase (predominantly diabetic neuropathic group). A trend of lower cross-correlations between segments was observed in the cohorts with diabetes.
  
  
  CONCLUSIONS
  Our findings suggest an alteration in segmental kinematics and coupling during walking in diabetic patients with and without neuropathy. Future studies should integrate other biomechanical measurements as it is believed to provide additional insight into neural and mechanical deficits associated to the foot in diabetes.
authors.affiliation: KU Leuven, Department of Rehabilitation Sciences, Musculoskeletal Rehabilitation Research Group, Weligerveld 1, 3212 Pellenberg, Belgium; KU Leuven, Laboratory for Clinical Motion Analysis, University Hospital Pellenberg, Weligerveld 1, 3212 Pellenberg, Belgium; KU Leuven, Multidisciplinary Diabetic Foot Clinic, University Hospitals Leuven, Weligerveld 1, 3212 Pellenberg, Belgium; Institut D'Enseignement Supérieur Parnasse Deux-Alice, Division of Podiatry, Bruxelles, Weligerveld 1, 3212 Pellenberg, Belgium. Electronic address: kevin.deschamps@uz.kuleuven.ac.be.
authors.forename: K
authors.initials: K
authors.lastname: Deschamps
authors.forename: G A
authors.initials: GA
authors.lastname: Matricali
authors.forename: P
authors.initials: P
authors.lastname: Roosen
authors.forename: F
authors.initials: F
authors.lastname: Nobels
authors.forename: J
authors.initials: J
authors.lastname: Tits
authors.forename: K
authors.initials: K
authors.lastname: Desloovere
authors.forename: H
authors.initials: H
authors.lastname: Bruyninckx
authors.forename: M
authors.initials: M
authors.lastname: Flour
authors.forename: P-A
authors.initials: PA
authors.lastname: Deleu
authors.forename: W
authors.initials: W
authors.lastname: Verhoeven
authors.forename: F
authors.initials: F
authors.lastname: Staes
mesh_terms: D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D005528:Foot / Q000502:physiology / Q000503:physiopathology*; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D011312:Pressure; D016059:Range of Motion, Articular / Q000502:physiology; D012016:Reference Values; D016138:Walking / Q000502:physiology
keywords: Diabetes; Foot; Gait; Joint mobility; Neuropathy