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1.
Diabetes Res Clin Pract ; 202: 110810, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37391033

ABSTRACT

The ability of the Ipswich touch test (IpTT) and VibratipTM to detect loss of protective sensation (LOPS) was tested against a neurothesiometer in an outpatient diabetic population without a history for ulceration. Our results support the use of the IpTT as a screening tool for LOPS, but not of VibratipTM.


Subject(s)
Diabetes Mellitus , Diabetic Foot , Diabetic Neuropathies , Humans , Diabetic Foot/prevention & control , Touch , Outpatients , Sensory Thresholds , India/epidemiology , Diabetic Neuropathies/diagnosis
2.
Diabetes Res Clin Pract ; 187: 109865, 2022 May.
Article in English | MEDLINE | ID: mdl-35398144

ABSTRACT

AIMS: Literature indicates that altered plantar loading in people with diabetes could trigger changes in plantar soft tissue biomechanics which, in turn, could affect the risk for ulceration. To stimulate more research in this area, this study uses in vivo testing to investigate the link between plantar loading and tissue hardness. METHODS: Tissue hardness and plantar pressure distribution were measured for six plantar areas in 39 people with diabetes and peripheral neuropathy. RESULTS: Spearman correlation analysis revealed that increased pressure time integral at the 1st metatarsal-head region (r = -0.354, n = 39, P = 0.027) or at the heel (r = -0.378, n = 39, P = 0.018) was associated with reduced hardness in the same regions. After accounting for confounding parameters, generalised estimating equations analysis also showed that 10% increase in pressure time integral at the heel was associated with ≈ 1 unit reduction in hardness in the same region. CONCLUSIONS: For the first time, this study reveals that people with diabetes and neuropathy who tend to load their feet more heavily also tend to have plantar soft tissues with lower hardness. The observed difference in tissue hardness is likely to affect the tissue's vulnerability to overload injury. More research will be needed to explore the implications of the observed association for the risk of ulceration.


Subject(s)
Diabetes Mellitus , Diabetic Foot , Peripheral Nervous System Diseases , Foot , Hardness , Heel , Humans
3.
Diabetes Res Clin Pract ; 126: 182-191, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28259007

ABSTRACT

AIM: To investigate if the assessment of the mechanical properties of plantar soft tissue can increase the accuracy of predicting Diabetic Foot Ulceration (DFU). METHODS: 40 patients with diabetic neuropathy and no DFU were recruited. Commonly assessed clinical parameters along with plantar soft tissue stiffness and thickness were measured at baseline using ultrasound elastography technique. 7 patients developed foot ulceration during a 12months follow-up. Logistic regression was used to identify parameters that contribute to predicting the DFU incidence. The effect of using parameters related to the mechanical behaviour of plantar soft tissue on the specificity, sensitivity, prediction strength and accuracy of the predicting models for DFU was assessed. RESULTS: Patients with higher plantar soft tissue thickness and lower stiffness at the 1st Metatarsal head area showed an increased risk of DFU. Adding plantar soft tissue stiffness and thickness to the model improved its specificity (by 3%), sensitivity (by 14%), prediction accuracy (by 5%) and prognosis strength (by 1%). The model containing all predictors was able to effectively (χ2 (8, N=40)=17.55, P<0.05) distinguish between the patients with and without DFU incidence. CONCLUSION: The mechanical properties of plantar soft tissue can be used to improve the predictability of DFU in moderate/high risk patients.


Subject(s)
Biomechanical Phenomena/physiology , Diabetic Foot/diagnosis , Foot/pathology , Foot/physiopathology , Aged , Diabetic Foot/pathology , Diabetic Neuropathies/diagnosis , Diabetic Neuropathies/physiopathology , Female , Foot/diagnostic imaging , Humans , Male , Middle Aged , Organ Size , Predictive Value of Tests , Prognosis , Prospective Studies , Sensitivity and Specificity , Severity of Illness Index , Ultrasonography
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