History, Prevalence and Assessment of Limited Joint Mobility, from Stiff Hand Syndrome to Diabetic Foot Ulcer Prevention: A Narrative Review of the Literature

Francia, Piergiorgio; Anichini, Roberto; Seghieri, Giuseppe; Bellis, Alessandra De; Gulisano, Massimo

doi:10.2174/1573399813666170816142731

Cited by 30 publications

(55 citation statements)

References 121 publications

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“…Regarding the relationship between LJM and disease duration, it is known that diabetes induces alterations of the connective tissues early and it may result in a widespread stiffness …”

Section: Discussionmentioning

confidence: 99%

“…As a result, LJM is a complication that begins developing at disease onset, can affect young patients, and its prevalence is higher in subjects with long‐term disease …”

Section: Introductionmentioning

confidence: 99%

“…In addition to known factors such as the metabolic control maintained and diabetes duration, others unknown can also contribute to an increased stiffness of skin, joint capsule, ligaments, and tendons and then to the development of LJM …”

Section: Introductionmentioning

confidence: 99%

“…On the contrary, it has been shown that just a few weeks of exercise training program can improve joint mobility in patients with diabetes . Even in young subjects it has been suggested that lifestyle and sports practiced can modify their LJM …”

Section: Introductionmentioning

confidence: 99%

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Type 1 diabetes, sport practiced, and ankle joint mobility in young patients: What is the relationship?

Francia

Toni

Iannone³

et al. 2018

Pediatr Diabetes

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Background/Objective It is known that patients with diabetes can develop limited joint mobility (LJM) and that this can depend on the metabolic control maintained and the duration of the disease. The aims of this study were to verify the presence of ankle joint mobility (AJM) deficits in both plantar and dorsiflexion in young type 1 diabetic patients (T1D) considering also the possible role of sport practiced as a further factor, able to modify AJM. Methods AJM was evaluated by an inclinometer in 82 T1D patients (M/F: 48/34), mean age 12.9 ± 2.6 years, body mass index (BMI) 19.7 ± 3.6 kg/m2, duration of diabetes 5.6 ± 3.3 years, mean HbA1c 7.5 ± 1.0% and in 226 healthy controls (M/F: 146/80), age‐, gender‐, and BMI‐matched practicing different sports (soccer, volleyball, basketball, and dance). Results The patients’ ankle range of motion was significantly lower than that in controls (132.7 ± 22.3° vs 126.1 ± 17.9°; P < .017). In particular, ankle plantar flexion was significantly lower in the patients group (31.6° ± 7.9° vs 28.5° ± 6.6°; P < .002). Soccer players showed lower AJM in both groups: patients (120.1 ± 15.9° vs 127.3 ± 18.1) and controls (119.4 ± 21.1° vs 142.0 ± 18.1; P < .0001) than subjects practicing other sports or who were sedentary. In both groups, patients and controls, age, sex, duration of disease, hemoglobin 1Ac, and BMI have not been shown to be correlated to the mobility assessed. Conclusions The results of this study, in addition to confirming the negative effect of diabetes on AJM of young T1D patients, suggest that during these evaluations the sport‐related effect should be considered because it can induce significant changes of AJM.

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“…Regarding the relationship between LJM and disease duration, it is known that diabetes induces alterations of the connective tissues early and it may result in a widespread stiffness …”

Section: Discussionmentioning

confidence: 99%

“…As a result, LJM is a complication that begins developing at disease onset, can affect young patients, and its prevalence is higher in subjects with long‐term disease …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Type 1 diabetes, sport practiced, and ankle joint mobility in young patients: What is the relationship?

Francia

Toni

Iannone³

et al. 2018

Pediatr Diabetes

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“…The prevalence of DM is as high as 25% in the elderly population, particularly in men aged >65 years. Diabetic foot is one of the major syndromes of DM [1], which might manifest as intermittent claudication, resting pain, and poor-healing ulcers. Approximately 25% of patients with DM require major limb amputation during hospitalization for diabetic foot ulcers [2].…”

Section: Introductionmentioning

confidence: 99%

Impaired cutaneous T‐cell attracting chemokine elevation and adipose‐derived stromal cell migration in a high‐glucose environment cause poor diabetic wound healing

Wang

Lee

Wang

et al. 2018

The Kaohsiung J of Med Scie

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Diabetic wound care is a major health care concern. The major cause of non‐healing of wounds in patients with diabetes mellitus (DM) patients mainly involves poor glycemic control, which hinders the migration of progenitor cells including mesenchymal stem cells to the wound site. In this study, we introduced adipose‐derived stromal cells (ADSCs) into wound sites and demonstrated that the local transplantation of ADSCs accelerated DM‐related wound healing. Furthermore, the migration ability of ADSCs, which diminishes in a high‐glucose environment, was partially restored by the exogenous replenishment of the cutaneous T‐cell attracting chemokine (CTACK/CCL27). Our findings suggest that CTACK is a potential novel therapeutic target in DM‐related wound healing.

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Systematic review and meta‐analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance

Lepesis

Marsden

Rickard

et al. 2023

Diabetes Metabolism Res

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To evaluate the effects of foot and ankle physical therapy on ankle and first metatarsophalangeal joint range of motion (ROM), peak plantar pressures (PPPs) and balance in people with diabetes. MEDLINE, EBSCO, Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database of Systematic Reviews, PROSPERO, EThOS, Web of Science and Google Scholar were searched in April 2022. Randomised Controlled Trials (RCT), quasi‐experimental, pre‐post experimental design and prospective cohort studies were included. Participants were people with diabetes, neuropathy and joint stiffness. Interventions included physical therapy such as mobilisations, ROM exercises and stretches. Outcome measures focused on ROM, PPPs and balance. Methodological quality was assessed with Critical Appraisal Skills Programme RCT and Risk‐of‐Bias 2 tool. Meta‐analyses used random‐effects models and data was analysed using the inverse variance method. In total, 9 studies were included. Across all studies, participant characteristics were similar; however, type and exercise dosage varied greatly. Meta‐analysis was performed with four studies. Meta‐analysis showed significant effects of combined exercise interventions in increasing total ankle ROM (3 studies: MD, 1.76; 95% CI, 0.78–2.74; p = 0; I2 = 0%); and reducing PPPs in the forefoot area (3 studies; MD, −23.34; 95% CI, −59.80 to 13.13; p = 0.21, I2 = 51%). Combined exercise interventions can increase ROM in the ankle and reduce PPPs in the forefoot. Standardisation of exercise programmes with or without the addition of mobilisations in the foot and ankle joints needs further research.

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History, Prevalence and Assessment of Limited Joint Mobility, from Stiff Hand Syndrome to Diabetic Foot Ulcer Prevention: A Narrative Review of the Literature

Abstract: Difficulties encountered in the definition of the prevalence of LJM may hinder its study and the establishment of preventive interventions. However, LJM plays a key role in the monitoring of patients, especially those at risk for ulcer.

Cited by 30 publications

References 121 publications

Type 1 diabetes, sport practiced, and ankle joint mobility in young patients: What is the relationship?

Type 1 diabetes, sport practiced, and ankle joint mobility in young patients: What is the relationship?

Impaired cutaneous T‐cell attracting chemokine elevation and adipose‐derived stromal cell migration in a high‐glucose environment cause poor diabetic wound healing

Systematic review and meta‐analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance

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