Abnormal viscoelastic behaviour of passive ankle joint movement in diabetic patients: an early or a late complication?

Abstract

Aims/hypothesis: The goal of the present study was to compare the range of motion and both the viscous and elastic components of passive ankle joint movement in short-and long-term diabetic patients with that of a control population. Methods: Thirty-four diabetic patients and 16 control subjects entered into the study. Patients with a history of over 15 years of diabetes were considered as a longterm diabetic group. In order to quantify the passive ankle joint movement, a device was designed to measure the dorsi-and plantar-flexion angle and the net moment at the ankle. Elastic behaviour was examined as the separate slope of regression lines (stiffness) of plantar and dorsal components in the loading moment-angle curve. It was also examined as the slope of the regression line in the final 10% of each component. Hysteresis, a characteristic of viscoelastic materials that indicates loss of energy during unloading, was corrected for range of motion and used to examine viscous behaviour of the ankle joint. Results: Total and plantar ranges of motion were significantly lower in longterm diabetic patients than in short-term diabetic and control groups (p<0.05). Plantar-flexion stiffness was significantly lower in short-term diabetic patients than in control subjects and long-term diabetic groups (p<0.05). Corrected hysteresis was significantly higher in long-term diabetic than in short-term diabetic and control (p<0.05) groups in the dorsal range of motion. Conclusions/interpretation: This study shows that both decreased plantar and total ankle joint ranges of motion, and increased viscous component of passive ankle joint movement are among the late complications of diabetes.

An equinus deformity of the ankle accounts for only a small amount of the increased forefoot plantar pressure in patients with diabetes

“…The potentiometer on the foot segment was connected to that of the shank by a parallel linkage to ensure accurate measurement of the ankle between the two segments and to compensate for the polycentric nature of the ankle. Other authors have recently developed similar devices 16,17 to quantify equinus objectively in diabetic subjects. These devices have not included any method of dealing with malalignment of the device with regard to the centre of the ankle or the polycentricity issue during movement.…”

Assessment of lower leg muscle force distribution during isometric ankle dorsi and plantar flexion in patients with diabetes: a preliminary study

“…Although, most in vivo studies have analyzed muscle performance under isokinetic conditions (both active (Hatef, Bahrpeyma, & Tehrani, 2014) and passive (Hajrasouliha, Tavakoli, Esteki, & Nafisi, 2005)), a simple, widely used and objective tool in a clinic for measuring muscle strength is hand-held dynamometer (Abizanda et al, 2012). Hand-held dynamometers have been shown to be reliable for testing a number of muscle groups including those of the ankle (Burns, Redmond, Ouvrier, & Crosbie, 2005;Wang, Olson, & Protas, 2002), but this device does not give any information about the individual muscle forces distribution.…”

Optimization in measurement of MVC and active stiffness in wrist using the quick release method

“…This is why researchers had tried to find objective methods for these evaluations [1][2][3][4][5][6]. It should be mentioned that these objective efforts were not specified for measurements in wrist and had been done for other human joints like elbow and ankle [7][8][9][10][11][12][13][14].…”