Anichini, Roberto

Francia, Piergiorgio

Gulisano, Massimo

Lazzeri, Renzo

Paternostro, Ferdinando

Seghieri, Giuseppe

Toni, Sonia

English

Florence Research

IJAE Vo l .  120 ,  n .  1  (Supp lem ent) :  20 0 ,  2015© 2015 Firenze University Press ht tp://www.fupress .com/ijaeITALIAN JOURNAL OF ANATOMY AND EMBRYOLOGYDiabetes, ankle joint mobility, aging, and foot ulcer Piergiorgio Francia1, Ferdinando Paternostro1, Roberto Anichini2, Sonia Toni3, Giuseppe Seghieri4, Renzo Lazzeri1, Massimo Gulisano11 Department of Clinical and Experimental Medicine, Università degli Studi di Firenze, Firenze, Italy - 2 Diabetes Unit, USL 3, Spedali Riuniti, Pistoia, Italy - 3 Diabetes Unit, Meyer Children’s Hospital, Firenze, Italy - 4 Tuscany Regional Health Agency (ARS), Firenze, ItalyIn diabetic patients the evaluation of how ankle joint mobility (AJM) can be useful in the identification of connective tissue alteration and risk of foot ulcer (FU). Plantar and dorsal flexion of foot were evaluated using an inclinometer in 87 patients (54 type 2 and 33 type 1), and 35 healthy sex- and age-matched control sub-jects. Patients with diabetes were followed up for diagnosis of FU over the next 8 years and subsequently, patients were subdivided into: those without a history of FU (18 type 1 and 33 type 2), those who had a history of FU detected before baseline evaluation (14 type 2) and those who had history of first ulceration detected by the 8th year of the evaluation period (7 type 2).  Aging and diabetes caused a significant reduction in mobility of each of the movements investigated (p < 0.001), whereas after adjusting for the confounding effect of age, diabetes specifically reduced plantar flexion (p < 0.0001). AJM was significantly lower in those with history of previous FU compared to all the other groups (p < 0.001). The first ulceration was detected in the same foot presenting low-er AJM in 17 of the 22 subjects with diabetes with history of ulcer (77.27%). Diabetes and aging reduce AJM although diabetes seems to reduce plantar flexion to a more specific extent. Reduced AJM is mostly associated with a previous history of FU. The evaluation of AJM is a valid and reliable ulcer risk scale that indicates which foot is at higher ulcer risk.Keywords Diabetic foot. Ankle range of motion; Limited joint mobility; Foot ulcer risk scale.

Diabetes, ankle joint mobility, aging and foot ulcer

https://flore.unifi.it/bitstream/2158/1006388/2/diabetes2015.pdf

Diabetes, ankle joint mobility, aging and foot ulcer

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