Article

The purpose of this study was to compare in-vivo kinematic angular excursions of
individual metatarsal segments and a unified forefoot segment in people with
Diabetes Mellitus and peripheral neuropathy (DMPN) without deformity or
ulceration to a healthy matched control group. Thirty subjects were recruited. A
five- segment foot model
(1st, 3rd, and 5th metatarsals, calcaneus, tibia) was
used to examine relative 3D angular excursions during the terminal stance phase
of walking. Student t-tests were used to assess group differences in kinematics.
Pearson correlations and cross-correlations were used to assess relationships
between the motion of the individual metatarsals and the unified forefoot.
Significant reductions of DMPN group sagittal plane angular excursions were
detected in all individual metatarsals and the unified forefoot (p < 0.01).
Frontal plane 3rd metatarsal excursion was reduced (p = 0.04) in the DMPN group.
The 3rd and 5th metatarsal and the unified forefoot excursions were reduced (p
</= 0.02) in the DMPN group in the transverse plane. In both groups, coupling of
individual metatarsal and unified forefoot motion was strongest in the sagittal
plane. This study illustrates that multiple individual metatarsals have reduced
motion in people with DMPN. Differences in the magnitude and coupling between
individual metatarsal motion and unified forefoot motion supports the use of a
two segment forefoot modeling approach in future kinematic analyses. Further
study is recommended to determine if the observed kinematic profile is related to
the development and location of deformity and tissue breakdown in people with
DMPN.
CI - Copyright (c) 2015 Elsevier B.V. All rights reserved.

Langue : ANGLAIS