Analysis of Clinical Profiles, Deformities, and Plantar Pressure Patterns in Diabetic Foot Syndrome

Diabetic foot syndrome refers to heterogeneous clinical and biomechanical profiles, which render predictive models unsatisfactory. A valuable contribution may derive from identification and descriptive analysis of well-defined subgroups of patients. Clinics, biology, function, gait analysis, and pla...

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Bibliographic Details
Published in:Applied sciences 2021-12, Vol.11 (23), p.11464
Main Authors: Giacomozzi, Claudia, Lullini, Giada, Leardini, Alberto, Caravaggi, Paolo, Ortolani, Maurizio, Marchesini, Giulio, Baccolini, Luca, Berti, Lisa
Format: Article
Language:English
Subjects:
Ankle
Biomechanical engineering
Biomechanics
Bones
Cardiovascular disease
Diabetes
Diabetes mellitus
Feet
foot alignment
Foot diseases
Gait
Gender
Hemoglobin
Kinematics
Laboratories
Lesions
neuropathy
Obesity
Orthopedics
Patients
Peak pressure
Plantar pressure
plantar pressure profiles
Prediction models
Pressure
Regression analysis
Statistical analysis
Subgroups
Ulcers
Variables
Vein & artery diseases
weight-bearing CT
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Summary:Diabetic foot syndrome refers to heterogeneous clinical and biomechanical profiles, which render predictive models unsatisfactory. A valuable contribution may derive from identification and descriptive analysis of well-defined subgroups of patients. Clinics, biology, function, gait analysis, and plantar pressure variables were assessed in 78 patients with diabetes. In 15 of them, the 3D architecture of the foot bones was characterized by using weight-bearing CT. Patients were grouped by diabetes type (T1, T2), presence (DN) or absence (DNN) of neuropathy, and obesity. Glycated hemoglobin (HbA1c) and plantar lesions were monitored during a 48-month follow-up. Statistical analysis showed significant differences between the groups for at least one clinical (combined neuropathy score, disease duration, HbA1c), biological (age, BMI), functional (joint mobility, foot alignment), or biomechanical (regional peak pressure, pressure-time integral, cadence, velocity) variable. Twelve patients ulcerated during follow-up (22 lesions in total), distributed in all groups but not in the DNN T2 non-obese group. These showed biomechanical alterations, not always occurring at the site of lesion, and HbA1c and neuropathy scores higher than the expected range. Three of them, who also had weight-bearing CT analysis, showed >40% of architecture parameters outside the 95%CI. Appropriate grouping and profiling of patients based on multi-instrumental clinical and biomechanical analysis may help improve prediction modelling and management of diabetic foot syndrome.
ISSN:2076-3417
2076-3417
DOI:10.3390/app112311464