Hyo-Jung Jeong1, Michael J Mueller2, Jennifer A Zellers2, Paul K Commean3, Ling Chen4, Mary K Hastings5. 1. Orthopaedic and Rehabilitation Engineering Center, Marquette University, 1515 W. Wisconsin Ave., Milwaukee, WI 53233, USA; Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, PO Box 413, Milwaukee, WI 53201, USA. 2. Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave., St. Louis, MO 63108, USA. 3. Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, 4525 Scott Ave., St. Louis, MO 63110, USA. 4. Division of Biostatistics, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO 63110, USA. 5. Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave., St. Louis, MO 63108, USA. Electronic address: hastingsmk@wustl.edu.
Abstract
PURPOSE: Midfoot movement dysfunction, as measured by heel rise performance, is associated with midfoot deformity in people with diabetes and peripheral neuropathy. Understanding contributors of midfoot movement dysfunction may help clinicians understand deformity progression. The purpose of this study was to determine the factors associated with midfoot angle at peak heel rise. METHODS: The outcomes of fifty-eight participants with type 2 diabetes mellitus and peripheral neuropathy were analyzed. Midfoot (forefoot on hindfoot) sagittal kinematics during unilateral heel rise task were measured using 3-dimensional motion analysis. A multivariate linear regression model was used to predict midfoot sagittal movements at peak heel rise. Independent variables that were entered in the model were (in order of entry): age, body mass index, intrinsic foot muscle volume, and maximum available midfoot plantarflexion range of motion. Intrinsic foot muscle volume was obtained from magnetic resonance imaging and maximum available midfoot motion was measured during non-weightbearing plantarflexion using 3-dimensional motion analysis. RESULTS: Body mass index (R2 = 30.5%, p < 0.001) and maximum available midfoot plantarflexion range of motion (R2 = 10.9%, p = 0.001) were significant factors that accounted for 41.4% of variance of midfoot angle at peak heel rise, while age and intrinsic foot muscle volume were not significant predictors. CONCLUSIONS: Greater body mass index and less available midfoot plantarflexion range of motion were associated with greater midfoot movement dysfunction. These two significant predictors are potentially modifiable, suggesting possible improvements in midfoot movements with reduction in body weight and increasing midfoot plantarflexion range of motion. Health care professionals should consider patient's weight and joint motion when prescribing foot exercise(s) to prevent excessive midfoot collapse during weightbearing tasks.
PURPOSE: Midfoot movement dysfunction, as measured by heel rise performance, is associated with midfoot deformity in people with diabetes and peripheral neuropathy. Understanding contributors of midfoot movement dysfunction may help clinicians understand deformity progression. The purpose of this study was to determine the factors associated with midfoot angle at peak heel rise. METHODS: The outcomes of fifty-eight participants with type 2 diabetes mellitus and peripheral neuropathy were analyzed. Midfoot (forefoot on hindfoot) sagittal kinematics during unilateral heel rise task were measured using 3-dimensional motion analysis. A multivariate linear regression model was used to predict midfoot sagittal movements at peak heel rise. Independent variables that were entered in the model were (in order of entry): age, body mass index, intrinsic foot muscle volume, and maximum available midfoot plantarflexion range of motion. Intrinsic foot muscle volume was obtained from magnetic resonance imaging and maximum available midfoot motion was measured during non-weightbearing plantarflexion using 3-dimensional motion analysis. RESULTS: Body mass index (R2 = 30.5%, p < 0.001) and maximum available midfoot plantarflexion range of motion (R2 = 10.9%, p = 0.001) were significant factors that accounted for 41.4% of variance of midfoot angle at peak heel rise, while age and intrinsic foot muscle volume were not significant predictors. CONCLUSIONS: Greater body mass index and less available midfoot plantarflexion range of motion were associated with greater midfoot movement dysfunction. These two significant predictors are potentially modifiable, suggesting possible improvements in midfoot movements with reduction in body weight and increasing midfoot plantarflexion range of motion. Health care professionals should consider patient's weight and joint motion when prescribing foot exercise(s) to prevent excessive midfoot collapse during weightbearing tasks.
Authors: Victor A Cheuy; Mary K Hastings; Paul K Commean; Samuel R Ward; Michael J Mueller Journal: Clin Biomech (Bristol, Avon) Date: 2013-10-12 Impact factor: 2.063
Authors: Paul K Commean; Lori J Tuttle; Mary K Hastings; Michael J Strube; Michael J Mueller Journal: J Magn Reson Imaging Date: 2011-09-30 Impact factor: 4.813
Authors: Paul A Butterworth; Donna M Urquhart; Karl B Landorf; Anita E Wluka; Flavia M Cicuttini; Hylton B Menz Journal: Gait Posture Date: 2014-11-24 Impact factor: 2.840
Authors: Mary K Hastings; David R Sinacore; James Woodburn; E Scott Paxton; Sandra E Klein; Jeremy J McCormick; Kathryn L Bohnert; Krista S Beckert; Michelle L Stein; Michael J Strube; Jeffrey E Johnson Journal: Clin Biomech (Bristol, Avon) Date: 2013-05-15 Impact factor: 2.063
Authors: Mary K Hastings; James Woodburn; Michael J Mueller; Michael J Strube; Jeffrey E Johnson; David R Sinacore Journal: Clin Biomech (Bristol, Avon) Date: 2014-08-27 Impact factor: 2.063
Authors: Dana Dabelea; Elizabeth J Mayer-Davis; Sharon Saydah; Giuseppina Imperatore; Barbara Linder; Jasmin Divers; Ronny Bell; Angela Badaru; Jennifer W Talton; Tessa Crume; Angela D Liese; Anwar T Merchant; Jean M Lawrence; Kristi Reynolds; Lawrence Dolan; Lenna L Liu; Richard F Hamman Journal: JAMA Date: 2014-05-07 Impact factor: 56.272