Literature DB >> 12474190

Plantar tissue stiffness in patients with diabetes mellitus and peripheral neuropathy.

Joseph W Klaesner1, Mary K Hastings, Dequan Zou, Cara Lewis, Michael J Mueller.   

Abstract

OBJECTIVE: To determine if a difference exists in the plantar soft tissue of patients with diabetes mellitus (DM) and peripheral neuropathy (PN) compared with age-matched controls.
DESIGN: Case-control study with a parallel 3-element 1-dimensional viscoelastic model developed to characterize indentation data.
SETTING: Data collection performed in an academic physical therapy laboratory. PARTICIPANTS: Forty subjects were recruited into 2 groups (20 subjects with DM, PN, and history of plantar ulcers; 20 control subjects), matched for age (DM: 55.22+/-9.39 y; control: 55.91+/-10.97 y), gender (DM: 14 men, 6 women; control: 14 men, 6 women), and body mass index (DM: 32.96+/-8.39 kg/m(2); control: 32.58+/-7.69 kg/m(2)).
INTERVENTIONS: The plantar soft tissue stiffness was measured over the first, third, and fifth metatarsals, and heel of each subject using an indentor system that accurately measures force/displacement (F/D) data. A parallel 3-element viscoelastic mechanical model was then used to transform the F/D data into values that were used to make stiffness assessments. MAIN OUTCOME MEASURE: The element coefficients of our model indicated the stiffness of the plantar tissue.
RESULTS: The plantar tissue of the subjects with DM over the metatarsal heads was stiffer than the control population as indicated by one of the spring constants in the parallel 3-element model (first: 1.13+/-0.55 N/mm vs.72+/-.32 N/mm; third:.96+/-.32 N/mm vs.79+/-.17 N/mm; fifth:.90+/-.31 N/mm vs.69+/-.28 N/mm; P<.05).
CONCLUSIONS: The plantar tissue of subjects with DM, PN, and a history of ulcers was stiffer than control subjects. However, additional research is needed to determine the relationship among increased soft tissue stiffness, plantar pressures, and skin breakdown. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Entities:  

Mesh:

Year:  2002        PMID: 12474190     DOI: 10.1053/apmr.2002.35661

Source DB:  PubMed          Journal:  Arch Phys Med Rehabil        ISSN: 0003-9993            Impact factor:   3.966


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