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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Abnormalities of plantar pressure distribution in early, intermediate, and late stages of diabetic neuropathy

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Author(s):
Sacco, Isabel C. N. [1] ; Hamamoto, Adriana N. [1] ; Tonicelli, Lucas M. G. [1] ; Watari, Ricky [1] ; Ortega, Neli R. S. [2] ; Sartor, Cristina D. [1]
Total Authors: 6
Affiliation:
[1] Univ Sao Paulo, Sch Med, Phys Therapy Speech & Occupat Therapy Dept, Sao Paulo - Brazil
[2] Univ Sao Paulo, Ctr Fuzzy Syst Hlth, Sch Med, Sao Paulo - Brazil
Total Affiliations: 2
Document type: Journal article
Source: GAIT & POSTURE; v. 40, n. 4, p. 570-574, SEP 2014.
Web of Science Citations: 16
Abstract

Inconsistent findings with regard to plantar pressure while walking in the diabetic population may be due to the heterogeneity of the studied groups resulting from the classification/grouping criteria adopted. The clinical diagnosis and classification of diabetes have inherent uncertainties that compromise the definition of its onset and the differentiation of its severity stages. A fuzzy system could improve the precision of the diagnosis and classification of diabetic neuropathy because it takes those uncertainties into account and combines different assessment methods. Here, we investigated how plantar pressure abnormalities evolve throughout different severity stages of diabetic polyneuropathy (absent, n = 38; mild, n = 20; moderate, n = 47; severe, n = 24). Pressure distribution was analysed over five areas while patients walked barefoot. Patients with mild neuropathy displayed an increase in pressure-time integral at the forefoot and a lower peak pressure at the heel. The peak and pressure-time integral under the forefoot and heel were aggravated in later stages of the disease (moderate and severe) compared with early stages of the disease (absent and mild). In the severe group, lower pressures at the lateral forefoot and hallux were observed, which could be related to symptoms that develop with the aggravation of neuropathy: atrophy of the intrinsic foot muscles, reduction of distal muscle activity, and joint stiffness. Although there were clear alterations over the forefoot and in a number of plantar areas with higher pressures within each severity stage, they did not follow the aggravation evolution of neuropathy classified by the fuzzy model. Based on these results, therapeutic interventions should begin in the early stages of this disease to prevent further consequences of the disease. (C) 2014 Elsevier B.V. All rights reserved. (AU)

FAPESP's process: 11/19304-4 - Influence of physical therapy intervention on foot and ankle biomechanics of gait in diabetic neuropatic individuals: a randomized controlled trial
Grantee:Cristina Dallemole Sartor
Support type: Scholarships in Brazil - Doctorate (Direct)