Acquired midfoot deformity and function in individuals with diabetes and peripheral neuropathy

Mary K. Hastings*, Michael J. Mueller, James Woodburn, Michael J. Strube, Paul Commean, Jeffrey E. Johnson, Victor Cheuy, David R. Sinacore

*Corresponding author for this work

    Research output: Contribution to journalArticle

    Abstract

    Background:
    Diabetes mellitus related medial column foot deformity is a major contributor to ulceration and amputation. However, little is known about the relationship between medial column alignment and function and the integrity of the soft tissues that support and move the medial column. The purposes of this study were to determine the predictors of medial column alignment and function in people with diabetes and peripheral neuropathy.

    Methods:
    23 participants with diabetes and neuropathy had radiographs, heel rise kinematics, magnetic resonance imaging and isokinetic muscle testing to measure: 1) medial column alignment (Meary's angle the angle between the 1st metatarsal longitudinal axis and the talar head and neck), 2) medial column function (forefoot relative to hindfoot plantarflexion during heel rise), 3) intrinsic foot muscle and fat volume, ratio of posterior tibialis to flexor digitorum tendon volume, 4) plantar fascia function (Meary's angle change from toes flat to extended) and 5) plantarflexor peak torque. Predictors of medial column alignment and function were determined using simultaneous entry multiple regression.

    Findings:
    Posterior tibialis to flexor digitorum tendon volume ratio and intrinsic foot muscle volume were significant predictors of medial column alignment (P < .05), accounting for 44% of the variance. Intrinsic foot fat volume and plantarflexor peak torque were significant predictors of medial column function (P < .05), accounting for 37% of the variance.

    Interpretation

    Deterioration of medial column supporting structures predicted alignment and function. Prospective research is required to monitor alignment, structure, and function over time to inform early intervention strategies to prevent deformity, ulceration, and amputation
    Original languageEnglish
    Pages (from-to)261-267
    Number of pages7
    JournalClinical Biomechanics
    Volume32
    Early online date7 Nov 2015
    DOIs
    Publication statusPublished - Feb 2016

    Keywords

    • Intrinsic foot muscle
    • Plantar flexor power
    • Posterior tibialis tendon
    • Muscle volume

    Fingerprint Dive into the research topics of 'Acquired midfoot deformity and function in individuals with diabetes and peripheral neuropathy'. Together they form a unique fingerprint.

  • Profiles

    Cite this

    Hastings, M. K., Mueller, M. J., Woodburn, J., Strube, M. J., Commean, P., Johnson, J. E., Cheuy, V., & Sinacore, D. R. (2016). Acquired midfoot deformity and function in individuals with diabetes and peripheral neuropathy. Clinical Biomechanics, 32, 261-267. https://doi.org/10.1016/j.clinbiomech.2015.11.001