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The relationship between passive range of motion and range of motion during gait and plantar pressure measurements
D. E. Turner, P. S. Helliwell, A. K. Burton and J. Woodburn Diabet. Med. 24, 1240 –1246 (2007)
Quote:
Aims To investigate the relationship between limited joint mobility (LJM; measured both passively and during gait) and plantar pressure measurements.
Methods A cross-sectional study involving 28 diabetic patients with peripheral neuropathy but no plantar ulceration (DN), 25 diabetic patients with ulceration (DU), 25 diabetic control patients with no ulceration or peripheral neuropathy (DC), and 25 non-diabetic reference subjects (NDR). Movements of the ankle joint complex (AJC) and 1st metatarsophalangeal (MTP) joint were recorded, together with plantar pressures.
Results The passive range of motion at the AJC was significantly reduced in all the diabetes groups, but the gait range of motion was comparable with non-diabetic subjects. At the AJC, no correlation was found between the passive and gait range of motion (ROM) and these were not correlated with plantar pressure variables. At the 1st MTP, a correlation was found between the passive and gait dorsiflexion ROM and a significant correlation existed between gait dorsiflexion ROM at the 1st MTP joint and peak forefoot pressures in the DU group.
Conclusions Despite a significant reduction in the passive ROM at the AJC in the diabetic groups, the gait ROM was indistinguishable from reference subjects and was not correlated with plantar pressure variables. At the 1st MTP joint, a correlation was found between the passive and gait ROM and furthermore the gait ROM was correlated with peak forefoot pressures, suggesting ROM measures at the 1st MTP joint may be preferable to ROM measures at the AJC.
What about subluxation of the hallux in diabetes in those with hallux abductovalgus? I always question the value of the measure of dorsiflexion of the hallux as an indicator of limited joint mobility in these cases and wonder if there is another indicator i should use
Passive and active ankle ROM in diabetes
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