Body mass index and maximum available midfoot motion are associated with midfoot angle at peak heel rise in people with type 2 diabetes mellitus and peripheral neuropathy.
Body mass index and maximum available midfoot motion are associated with midfoot angle at peak heel rise in people with type 2 diabetes mellitus and peripheral neuropathy.
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DOI：
10.1016/j.foot.2022.101912
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发表时间：
2022-05
期刊：
影响因子：
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通讯作者：
Hastings, Mary K
中科院分区：
文献类型：
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作者：
Jeong, Hyo-Jung;Mueller, Michael J;Zellers, Jennifer A;Commean, Paul K;Chen, Ling;Hastings, Mary K
中足运动功能障碍，如脚跟上升性能所测量的，与糖尿病和周围神经病变患者的中足畸形有关。了解中足运动功能障碍的原因可能有助于临床医生了解畸形进展。本研究的目的是确定与中足角度在峰值脚跟上升的因素。分析了58例2型糖尿病合并周围神经病变患者的结局。采用三维运动分析方法测量单侧足跟抬高任务中足中部（前足和后足）矢状面运动学。多元线性回归模型被用来预测峰值脚跟上升时的中足矢状运动。模型中输入的独立变量为（按输入顺序）：年龄、体重指数、固有足部肌肉体积和最大可用中足跖屈运动范围。通过磁共振成像获得固有的足部肌肉体积，并使用三维运动分析测量非负重跖屈期间的最大可用中足运动。体重指数（R2= 30.5%，p<0.001）和中足跖屈最大活动范围（R2= 10.9%，p=0.001）是重要因素，可解释足跟最大上升时中足角度方差的41.4%，而年龄和固有足部肌肉体积不是重要的预测因素。更大的身体质量指数和更少的中足跖屈运动范围与更大的中足运动功能障碍相关。这两个重要的预测因素是潜在的可修改的，这表明随着体重的减轻和中足跖屈运动范围的增加，中足运动可能得到改善。医疗保健专业人员在规定足部锻炼时应考虑患者的体重和关节活动，以防止在负重任务期间过度的中足塌陷。
Midfoot movement dysfunction, as measured by heel rise performance, is associated with midfoot deformity in people with diabetes and peripheral neuropathy. Understanding contributors of midfoot movement dysfunction may help clinicians understand deformity progression. The purpose of this study was to determine the factors associated with midfoot angle at peak heel rise. The outcomes of fifty-eight participants with type 2 diabetes mellitus and peripheral neuropathy were analyzed. Midfoot (forefoot on hindfoot) sagittal kinematics during unilateral heel rise task were measured using 3-dimensional motion analysis. A multivariate linear regression model was used to predict midfoot sagittal movements at peak heel rise. Independent variables that were entered in the model were (in order of entry): age, body mass index, intrinsic foot muscle volume, and maximum available midfoot plantarflexion range of motion. Intrinsic foot muscle volume was obtained from magnetic resonance imaging and maximum available midfoot motion was measured during non-weightbearing plantarflexion using 3-dimensional motion analysis. Body mass index (R2=30.5%, p<0.001) and maximum available midfoot plantarflexion range of motion (R2=10.9%, p=0.001) were significant factors that accounted for 41.4% of variance of midfoot angle at peak heel rise, while age and intrinsic foot muscle volume were not significant predictors. Greater body mass index and less available midfoot plantarflexion range of motion were associated with greater midfoot movement dysfunction. These two significant predictors are potentially modifiable, suggesting possible improvements in midfoot movements with reduction in body weight and increasing midfoot plantarflexion range of motion. Health care professionals should consider patient’s weight and joint motion when prescribing foot exercise(s) to prevent excessive midfoot collapse during weightbearing tasks.