TY - JOUR
T1 - Plantar tissue stiffness in patients with diabetes mellitus and peripheral neuropathy
AU - Klaesner, Joseph W.
AU - Hastings, Mary K.
AU - Zou, Dequan
AU - Lewis, Cara
AU - Mueller, Michael J.
PY - 2002/12/1
Y1 - 2002/12/1
N2 - 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±9.39y; control: 55.91±10.97y), gender (DM: 14 men, 6 women; control: 14 men, 6 women), and body mass index (DM: 32.96±8.39kg/m2; control: 32.58±7.69kg/m2). 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 Measures: 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±0.55N/mm vs .72c±.32N/mm; third: .96±.32 N/mm vs .79±.17N/mm; fifth: .90±.31N/mm vs .69±.28N/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.
AB - 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±9.39y; control: 55.91±10.97y), gender (DM: 14 men, 6 women; control: 14 men, 6 women), and body mass index (DM: 32.96±8.39kg/m2; control: 32.58±7.69kg/m2). 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 Measures: 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±0.55N/mm vs .72c±.32N/mm; third: .96±.32 N/mm vs .79±.17N/mm; fifth: .90±.31N/mm vs .69±.28N/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.
KW - Diabetes mellitus
KW - Foot ulcer
KW - Peripheral neuropathies
KW - Rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=0036897203&partnerID=8YFLogxK
U2 - 10.1053/apmr.2002.35661
DO - 10.1053/apmr.2002.35661
M3 - Article
C2 - 12474190
AN - SCOPUS:0036897203
VL - 83
SP - 1796
EP - 1801
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 12
ER -