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Journal of Foot and Ankle Research

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Gepubliceerd in: Journal of Foot and Ankle Research 1/2013

Open Access 01-12-2013 | Research

Lower leg muscle strengthening does not redistribute plantar load in diabetic polyneuropathy: a randomised controlled trial

Auteurs: Tom Melai, Nicolaas C Schaper, T Herman IJzerman, Ton LH de Lange, Paul JB Willems, Valéria Lima Passos, Aloysius G Lieverse, Kenneth Meijer, Hans HCM Savelberg

Gepubliceerd in: Journal of Foot and Ankle Research | Uitgave 1/2013

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Abstract

Background

Higher plantar pressures play an important role in the development of plantar foot ulceration in diabetic polyneuropathy and earlier studies suggest that higher pressures under the forefoot may be related to a decrease in lower leg muscle strength. Therefore, in this randomised controlled trial we evaluated whether lower-extremity strength training can reduce plantar pressures in diabetic polyneuropathy.

Methods

This study was embedded in an unblinded randomised controlled trial. Participants had diabetes and polyneuropathy and were randomly assigned to the intervention group (n = 48) receiving strength training during 24 weeks, or the control group (n = 46) receiving no intervention. Plantar pressures were measured in both groups at 0, 12, 24 and 52 weeks. A random intercept model was applied to evaluate the effects of the intervention on peak pressures and pressure–time-integrals, displacement of center-of-pressure and the forefoot to rearfoot pressure–time-integral-ratio.

Results

Plantar pressure patterns were not affected by the strength training. In both the intervention and control groups the peak pressure and the pressure–time-integral under the forefoot increased by 55.7 kPa (95% CI: 14.7, 96.8) and 2.0 kPa.s (95% CI: 0.9, 3.2) over 52 weeks, respectively. Both groups experienced a high number of drop-outs, mainly due to deterioration of health status and lower-extremity disabilities.

Conclusions

Plantar pressures under the forefoot increase progressively over time in people with diabetic polyneuropathy, but in this study were not affected by strength training. Future intervention studies should take this increase of plantar pressure into account and alternative interventions should be developed to reduce the progressive lower extremity problems in these patients.

Trial registration

This study was embedded in a clinical trial with trial number NCT00759265.
vorige artikel JFAR’s role in publishing believable research findings
volgende artikel Evaluation of multi-segmental kinematic modelling in the paediatric foot using three concurrent foot models
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Literatuur
1.
Allet L, Armand S, Golay A, Monnin D, de Bie RA, de Bruin ED: Gait characteristics of diabetic patients: a systematic review. Diabetes Metab Res Rev. 2008, 24 (3): 173-191. 10.1002/dmrr.809. CrossRefPubMed
2.
Caselli A, Pham H, Giurini JM, Armstrong DG, Veves A: The forefoot-to-rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration. Diabetes Care. 2002, 25 (6): 1066-1071. 10.2337/diacare.25.6.1066. CrossRefPubMed
3.
Pecoraro RE, Reiber GE, Burgess EM: Pathways to diabetic limb amputation. Basis for prevention. Diabetes Care. 1990, 13 (5): 513-521. CrossRefPubMed
4.
Valk GD, Kriegsman DM, Assendelft WJ: Patient education for preventing diabetic foot ulceration A systematic review. Endocrinol Metab Clin North Am. 2002, 31 (3): 633-658. 10.1016/S0889-8529(02)00021-X. CrossRefPubMed
5.
Mueller MJ, Zou D, Bohnert KL, Tuttle LJ, Sinacore DR: Plantar stresses on the neuropathic foot during barefoot walking. Phys Ther. 2008, 88 (11): 1375-1384. 10.2522/ptj.20080011. CrossRefPubMedPubMedCentral
6.
Bus SA, Valk GD, van Deursen RW, Armstrong DG, Caravaggi C, Hlavacek P, Bakker K, Cavanagh PR: Specific guidelines on footwear and offloading. Diabetes Metab Res Rev. 2008, 24 (Suppl 1): S192-S193. CrossRefPubMed
7.
Bus SA, Valk GD, van Deursen RW, Armstrong DG, Caravaggi C, Hlavacek P, Bakker K, Cavanagh PR: The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: a systematic review. Diabetes Metab Res Rev. 2008, 24 (Suppl 1): S162-S180. CrossRefPubMed
8.
Abboud RJ, Rowley DI, Newton RW: Lower limb muscle dysfunction may contribute to foot ulceration in diabetic patients. Clin Biomech (Bristol, Avon). 2000, 15 (1): 37-45. 10.1016/S0268-0033(99)00038-8. CrossRef
9.
Kwon OY, Minor SD, Maluf KS, Mueller MJ: Comparison of muscle activity during walking in subjects with and without diabetic neuropathy. Gait Posture. 2003, 18 (1): 105-113. 10.1016/S0966-6362(02)00166-2. CrossRefPubMed
10.
Savelberg HH, Ilgin D, Angin S, Willems PJ, Schaper NC, Meijer K: Prolonged activity of knee extensors and dorsal flexors is associated with adaptations in gait in diabetes and diabetic polyneuropathy. Clin Biomech (Bristol, Avon). 2010, 25 (5): 468-475. 10.1016/j.clinbiomech.2010.02.005. CrossRef
11.
Savelberg HH, Schaper NC, Willems PJ, de Lange TL, Meijer K: Redistribution of joint moments is associated with changed plantar pressure in diabetic polyneuropathy. BMC Musculoskelet Disord. 2009, 10: 16-10.1186/1471-2474-10-16. CrossRefPubMedPubMedCentral
12.
Melai T, Schaper NC, Ijzerman TH, De Lange ALH, Willems PJB, Meijer K, Lieverse AG, Savelberg HHCM: Increased forefootloading is associated with an increased plantar flexion moment. Hum Mov Sci. 2013, 10.1016/j.humov.2013.05.001
13.
IJzerman TH, Schaper NC, Melai T, Meijer K, Willems PJB, Savelberg HHCM: Lower extremity muscle strength is reduced in people with type 2 diabetes, with and without polyneuropathy, and is associated with impaired mobility and reduced quality of life. Diabetes Res Clin Pract. 2012, 95 (3): 345-351. 10.1016/j.diabres.2011.10.026. CrossRefPubMed
14.
van Schie CH, Vermigli C, Carrington AL, Boulton A: Muscle weakness and foot deformities in diabetes: relationship to neuropathy and foot ulceration in caucasian diabetic men. Diabetes Care. 2004, 27 (7): 1668-1673. 10.2337/diacare.27.7.1668. CrossRefPubMed
15.
Kouidi E, Albani M, Natsis K, Megalopoulos A, Gigis P, Guiba-Tziampiri O, Tourkantonis A, Deligiannis A: The effects of exercise training on muscle atrophy in haemodialysis patients. Nephrol Dial Transplant. 1998, 13 (3): 685-699. 10.1093/ndt/13.3.685. CrossRefPubMed
16.
Chetlin RD, Gutmann L, Tarnopolsky M, Ullrich IH, Yeater RA: Resistance training effectiveness in patients with Charcot-Marie-Tooth disease: recommendations for exercise prescription. Arch Phys Med Rehabil. 2004, 85 (8): 1217-1223. 10.1016/j.apmr.2003.12.025. CrossRefPubMed
17.
Valk GD, de Sonnaville JJ, van Houtum WH, Heine RJ, van Eijk JT, Bouter LM, Bertelsmann FW: The assessment of diabetic polyneuropathy in daily clinical practice: reproducibility and validity of Semmes Weinstein monofilaments examination and clinical neurological examination. Muscle Nerve. 1997, 20 (1): 116-118. 10.1002/(SICI)1097-4598(199701)20:1<116::AID-MUS19>3.0.CO;2-2. CrossRefPubMed
18.
Melai T, Ijzerman TH, Schaper NC, de Lange TL, Willems PJ, Meijer K, Lieverse AG, Savelberg HH: Calculation of plantar pressure time integral, an alternative approach. Gait Posture. 2011, 34 (3): 379-383. 10.1016/j.gaitpost.2011.06.005. CrossRefPubMed
19.
Monteiro MA, Gabriel RE, Neves ECM, Sousa MF, Abrantes JM, Moreira MH: Exercise effects in plantar pressure of postmenopausal women. Menopause. 2010, 17 (5): 1017-1025. 10.1097/gme.0b013e3181ddf6ef. CrossRefPubMed
20.
Delbridge L, Perry P, Marr S, Arnold N, Yue DK, Turtle JR, Reeve TS: Limited joint mobility in the diabetic foot: relationship to neuropathic ulceration. Diabet Med. 1988, 5 (4): 333-337. 10.1111/j.1464-5491.1988.tb01000.x. CrossRefPubMed
21.
van Deursen RW, Sanchez MM, Ulbrecht JS, Cavanagh PR: The role of muscle spindles in ankle movement perception in human subjects with diabetic neuropathy. Exp Brain Res. 1998, 120 (1): 1-8. 10.1007/s002210050371. CrossRefPubMed
22.
Courtemanche R, Teasdale N, Boucher P, Fleury M, Lajoie Y, Bard C: Gait problems in diabetic neuropathic patients. Arch Phys Med Rehabil. 1996, 77 (9): 849-855. 10.1016/S0003-9993(96)90269-5. CrossRefPubMed
23.
Grimm A, Kastenbauer T, Sauseng S, Sokol G, Irsigler K: Progression and distribution of plantar pressure in Type 2 diabetic patients. Diabetes Nutr Metab. 2004, 17 (2): 108-113. PubMed
24.
Veves A, Murray HJ, Young MJ, Boulton AJ: The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study. Diabetologia. 1992, 35 (7): 660-663. 10.1007/BF00400259. CrossRefPubMed
25.
Lavery LA, Armstrong DG, Wunderlich RP, Tredwell J, Boulton AJ: Predictive value of foot pressure assessment as part of a population-based diabetes disease management program. Diabetes Care. 2003, 26 (4): 1069-1073. 10.2337/diacare.26.4.1069. CrossRefPubMed
26.
Miralles-Garcia JM, de Pablos-Velasco P, Cabrerizo L, Perez M, Lopez-Gomez V: Prevalence of distal diabetic polyneuropathy using quantitative sensory methods in a population with diabetes of more than 10 years’ disease duration. Endocrinol Nutr. 2010, 57 (9): 414-420. 10.1016/j.endonu.2010.05.006. CrossRefPubMed
27.
Gill JM, Cooper AR: Physical activity and prevention of type 2 diabetes mellitus. Sports Med. 2008, 38 (10): 807-824. 10.2165/00007256-200838100-00002. CrossRefPubMed
28.
Hu FB, Leitzmann MF, Stampfer MJ, Colditz GA, Willett WC, Rimm EB: Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men. Arch Int Med. 2001, 161 (12): 1542-1548. 10.1001/archinte.161.12.1542. CrossRef
29.
Praet SF, van Rooij ES, Wijtvliet A, Boonman-de Winter LJ, Enneking T, Kuipers H, Stehouwer CD, van Loon LJ: Brisk walking compared with an individualised medical fitness programme for patients with type 2 diabetes: a randomised controlled trial. Diabetologia. 2008, 51 (5): 736-746. 10.1007/s00125-008-0950-y. CrossRefPubMedPubMedCentral
30.
Thoolen B, de Ridder D, Bensing J, Gorter K, Rutten G: Who participates in diabetes self-management interventions?: Issues of recruitment and retainment. Diabetes Educ. 2007, 33 (3): 465-474. 10.1177/0145721707301491. CrossRefPubMed
Metagegevens
Titel
Lower leg muscle strengthening does not redistribute plantar load in diabetic polyneuropathy: a randomised controlled trial
Auteurs
Tom Melai
Nicolaas C Schaper
T Herman IJzerman
Ton LH de Lange
Paul JB Willems
Valéria Lima Passos
Aloysius G Lieverse
Kenneth Meijer
Hans HCM Savelberg
Publicatiedatum
01-12-2013
Uitgeverij
BioMed Central
Gepubliceerd in
Journal of Foot and Ankle Research / Uitgave 1/2013
Elektronisch ISSN: 1757-1146
DOI
https://doi.org/10.1186/1757-1146-6-41

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