Kinetics and kinematics of diabetic foot in type 2 diabetes mellitus with and without peripheral neuropathy: a systematic review and meta-analysis

Abstract

Background Diabetes mellitus patients are at increased risk of developing diabetic foot with peripheral neuropathy, vascular and musculoskeletal complications. Therefore they are prone to develop frequent and often foot problems with a relative high risk of infection, gangrene and amputation. In addition, altered plantar pressure distribution is an important etiopathogenic risk factor for the development of foot ulcers. Thus the review on study of foot kinematic and kinetic in type 2 diabetes mellitus to understand the biomechanical changes is important.Methodology Scientific articles were obtained using electronic databases including Science Direct, CINAHL, Springer Link, Medline, Web of Science, and Pubmed. The selection was completed after reading the full texts. Studies using experimental design with focus on biomechanics of diabetic foot were selected.ResultsThe meta-analysis report on gait velocity (neuropathy = 128 and non-diabetes = 131) showed that there was a significantly lower gait velocity in neuropathy participants compared to non-diabetes age matched participants at a high effect level (−0.09, 95 % CI −0.13 to 0.05; p < 0.0001). Regarding knee joint flexion range there was a significant difference between neuropathy and non-diabetes group (4.75, 95 % CI, −7.53 to 1.97, p = 0.0008).ConclusionsThe systematic review with meta-analysis reported significant difference in kinematic and kinetic variables among diabetic with neuropathy, diabetic without neuropathy and non-diabetes individuals. The review also found that the sample size in some studies were not statistically significant to perform the meta-analysis and report a strong conclusion. Therefore a study with higher sample size should be done.

Structured exercise program on Foot Biomechanics & Insulin Resistance among people living with type 2 diabetes with and without peripheral neuropathy

“…There was also a significant clinical reduction in fasting insulin values. A previous study conducted from our center reported that even distribution of plantar pressure and correction of altered foot biomechanics could be an important factor for increasing foot mobility [3]. The present study found that there was a significant clinical mean reduction of 2.33 among participants without neuropathy and 1.05 among participants with neuropathy at three months post exercise intervention.…”

Foot Kinetic and Kinematic Profile in Type 2 Diabetes Mellitus with Peripheral Neuropathy

“…[20][21][22][23][24][25] Most of the studies suggested that participants with DPN have slower gait velocity compared with age-matched nonneuropathic patients with diabetes and healthy individuals. This finding was also supported by the meta-analysis by Hazari et al, 26 who concluded that there was a significantly lower gait velocity in participants with DPN (-0.09; 95% CI, -0.13 to 0.05; P , .0001). Similarly, the other spatiotemporal parameters, such as stride length and stance period, were reported to be significantly lower in participants with DPN.…”

Heart rate variability in type 2 diabetes mellitus: A systematic review and meta-analysis

“…The number of people with T2DM is predicted to double within the next three decades [1]. Besides macrovascular [7][8][9][10] and microvascular complications [11][12][13], the leading cause of death in T2DM is cardiovascular mortality [9]. Cardiovascular mortality has been related to the cardiac autonomic neuropathy frequently associated with T2DM [1,5,14].…”