Range of Motion and Plantar Pressure Evaluation for the Effects of Self-Care Foot Exercises on Diabetic Patients with and Without Neuropathy

2016 ◽  
Vol 106 (3) ◽  
pp. 189-200 ◽  
Author(s):  
Lale Cerrahoglu ◽  
Umut Koşan ◽  
Tuba Cerrahoglu Sirin ◽  
Aslihan Ulusoy

Background: We aimed to investigate whether a home exercise for self-care program that consists of range of motion (ROM), stretching, and strengthening exercises could improve ROM for foot joints and plantar pressure distribution during walking in diabetic patients to prevent diabetic foot complications. Methods: Seventy-six diabetic patients were recruited (38 with neuropathy and 38 without neuropathy). Neuropathy and nonneuropathy groups were randomly divided into a home exercise group (n = 19) and a control group (n = 19). Exercise groups performed their own respective training programs for 4 weeks, whereas no training was done in the control group. Total contact area and plantar pressure under six foot areas before and after the exercise program were measured. Ankle and first metatarsophalangeal joint ROM were measured before and after the exercise program. Results: In the exercise group, there were significant improvements in ROM for the ankle and first metatarsophalangeal joints (P < .001); static pedobarographic values showed significant reduction in right forefoot-medial pressure (P = .010); and significant decreases were seen in dynamic pedobarographic values of peak plantar pressure at the left forefoot medial (P = .007), right forefoot lateral (P = .018), left midfoot (P < .001), and right hindfoot (P = .021) after exercise. No significant positive or negative correlation was found between the neuropathy and nonneuropathy groups (P > .05). Conclusions: A home exercise program could be an effective preventive method for improving ROM for foot joints and plantar pressure distribution in diabetic patients independent of the presence of neuropathy.

2017 ◽  
Vol 43 (1) ◽  
pp. 40-48
Author(s):  
Veysi Çay ◽  
Gurbuz Buyukyazi ◽  
Cevval Ulman ◽  
Fatma Taneli ◽  
Yeliz Doğru ◽  
...  

AbstractObjectives:This study aims to examine effects of aerobic jogging and explosive power exercises on body composition, maximal oxygen consumption (MaxVOMaterials and methods:Thirty seven healthy males were divided into exercise group (EG, n=19) and control group (CG, n=18). EG completed 10 weeks of outdoor aerobic (jogging at 60–70% maximal heart rate reserve starting from 20 min steadily increasing up to 28 min) and explosive power exercises (in 2–3 sets, with maximum repetitions lasting 15 s), 3 times per week. All measurements were taken before and after the exercise program. BMD was measured via dual energy X-ray absorptiometry (DEXA).Results:Body mass index (p<0.001) significantly decreased; MaxVOConclusion:Performing our outdoor exercise program in spring months might have an important role in the significant increase (9 vs. 22 ng/mL) in mean vitamin D level, which reached above the fracture risk level of 20 ng/mL.


1996 ◽  
Vol 17 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Juan Carlos Garbalosa ◽  
Peter R. Cavanagh ◽  
Ge Wu ◽  
Jan S. Ulbrecht ◽  
Mary B. Becker ◽  
...  

The function of partially amputated feet in 10 patients with diabetes mellitus was studied. First-step bilateral barefoot plantar pressure distribution and three-dimensional kinematic data were collected using a Novel EMED platform and three video cameras. Analysis of the plantar pressure data revealed a significantly greater mean peak plantar pressure in the feet with transmetatarsal amputation (TMA) than in the intact feet of the same patients. The heels of the amputated feet had significantly lower mean peak plantar pressures than all the forefoot regions. A significantly greater maximum dynamic dorsiflexion range of motion was seen in the intact compared with the TMA feet. However, no difference was noted in the static dorsiflexion range of motion between the two feet and there was, therefore, a trend for the TMA feet to use less of the available range of motion. Given the altered kinematics and elevated plantar pressures noted in this study, careful postsurgical footwear management of feet with TMA would appear to be essential if ulceration is to be prevented.


2021 ◽  
pp. 1-9
Author(s):  
Warlindo Carneiro da Silva Neto ◽  
Alexandre Dias Lopes ◽  
Ana Paula Ribeiro

Context: Running is a popular sport globally. Previous studies have used a gait retraining program to successfully lower impact loading, which has been associated with lower injury rates in recreational runners. However, there is an absence of studies on the effect of this training program on the plantar pressure distribution pattern during running. Objective: To investigate the short-term effect of a gait retraining strategy that uses visual biofeedback on the plantar pressure distribution pattern and foot posture in recreational runners. Design: Randomized controlled trial. Setting: Biomechanics laboratory. Participants: Twenty-four recreational runners were evaluated (n = 12 gait retraining group and n = 12 control group). Intervention: Those in the gait retraining group underwent a 2-week program (4 sessions/wk, 30 min/session, and 8 sessions). The participants in the control group were also invited to the laboratory (8 times in 2 wk), but no feedback on their running biomechanics was provided. Main Outcome Measures: The primary outcome measures were plantar pressure distribution and plantar arch index using a pressure platform. The secondary outcome measure was the foot posture index. Results: The gait retraining program with visual biofeedback was effective in reducing medial and lateral rearfoot plantar pressure after intervention and when compared with the control group. In the static condition, the pressure peak and maximum force on the forefoot and midfoot were reduced, and arch index was increased after intervention. After static training intervention, the foot posture index showed a decrease in the foot pronation. Conclusions: A 2-week gait retraining program with visual biofeedback was effective in lowering rearfoot plantar pressure, favoring better support of the arch index in recreational runners. In addition, static training was effective in reducing foot pronation. Most importantly, these observations will help healthcare professionals understand the importance of a gait retraining program with visual biofeedback to improve plantar loading and pronation during rehabilitation.


2019 ◽  
Vol 13 (3) ◽  
pp. 263-269
Author(s):  
Djunizar Djamaludin ◽  
Setiawati Setiawati ◽  
Rika Yulendasari

The effect of range motion (ROM) ankle exercise on prevention of neuropathy and angiopathy in patient with diabetes mellitusBackground: Based on data from Basic Health Research (2013) conducted by the Indonesian Ministry of Health in a way to obtain the proportion of DM at the age of 15 years and over, confirmed / checked whether or not they suffer from DM or not.It was found that Lampung Province was ranked as the 8th largest DM person from 33 provinces throughout Indonesia, with DM patients with 38,923 lives and 5,560 people. One complication that needs attention is diabetes foot injury and it can cause amputation. The most common cause of diabetes foot injury is peripheral neuropathy which includes damage to sensory, autonomic and motor nerves.Purpose: The purpose of this study was to determine the effect of Range of Motion (ROM) ankle exercise on prevention of neuropathy and angiopathy on diabetes patients.Methods: A quasi experimental pre and post- test with control group study design was employed. The purposive sampling with 26 participants (13 respondents intervention group and 13 respondents control group) were recruited. The interventions groups performed ROM ankle exercise in their own respective training programs for 4 weeks, whereas no training was done in the control group. Both groups intervention and control, before and after the exercise program were measured with monofilament test for neuropathy and Venous Doppler for angiopathy. The data analysis was using t-test.Results: In the intervention group there were a significant improvements after ROM ankle exercise on prevention of neuropathy with p Value 0.000 and for angiopathy with p Value 0.000. There were significant different between intervention group and control group for neuropathy (p: .004) and angiopathy (p: .031).Conclusion: To prevent neuropathy and angiopathy on diabetes patients a home exercise program with Range of Motion (ROM) ankle could be implementedKeywords: Range of Motion; Neuropathy; Angiopathy; Diabetes MellitusPendahuluan: Berdasarkan Riskesdas tahun 2013 oleh Kemenkes RI dengan melakukan wawan cara untuk mendapatkan proporsi DM pada usia 15 tahun keatas yaitu proporsi penduduk yang terdiagnosis menderita DM dan penduduk yang belum pernah didiagnosis menderita DM. Provinsi Lampung menduduki peringkat ke – 8 penyandang DM terbesar dari 33 Provinsi diseluruh Indonesia, 38.923 jiwa dan 5.560 jiwa . Salah satu komplikasi yang harus mendapat perhatian yaitu luka kaki diabetes karena dapat mengakibarkan amputasi. Penyebab terbanyak dari luka kaki diabetes yaitu neuropati perifer yang meliputi kerusakan syaraf sensorik, otonom dan motorik.Tujuan: Diketahui pengaruh Range Of Motion (ROM) Ankle terhadap pencegahan terjadinya Neuropati dan Angiopati pada pasien Diabetes Melitus.Metode: Penelitian ini mengunakan desain quasi eksperimen pre post test dengan kelompok control dan intervensi..Sampel diambil dengan menggunakan tehnik Purposive Sampling dengan jumlah sampel yaitu 26 responden. Instrument penelitian ini  menggunakan 10 gr semmens weinstein monofilament untuk  mendeteksi  Neuropati dan  Venous Doppler  Ultrasound untuk  mendeteksi angiopati. Hasil: Menunjukkan adanya pengaruh latihan Range of Motion (ROM) Ankle terhadap pencegahan neuropati dengan p Value 0.000 dan angiopati dengan p Value 0.000. Terdapat perbedaan bermakna antara kelompok intervensi dan control untuk neuropati (p: .004) dan  angiopati  (p: .031).Simpulan: Untuk mencegah terjadinya neuropati dan angiopati pada penderita DM untuk dapat melakukan latihan Range of Motion (ROM) Ankle  dirumah


2019 ◽  
Vol 32 (12) ◽  
pp. 1341-1350 ◽  
Author(s):  
Junghwan Suh ◽  
Han Saem Choi ◽  
Ahreum Kwon ◽  
Hyun Wook Chae ◽  
Soyong Eom ◽  
...  

Abstract Background Previous studies investigating the beneficial effects of exercise in type 1 diabetes mellitus (T1DM) are relatively insufficient compared to studies on type 2 diabetes mellitus (T2DM), due to the fear of hypoglycemia. Recently, several researchers have reported that combined aerobic and resistance exercise prevents hypoglycemia during and after exercise. Furthermore, exercise has been shown to have beneficial effects on the psychological status of patients with various diseases. The aim of this study was to evaluate the effect of combined aerobic and resistance exercise in adolescents with T1DM. Methods Thirty-five type 1 diabetic patients were enrolled, and subjects were divided into either an exercise group or a control group. Thirty patients (20 patients in the exercise group, 10 patients in the control group) completed the study. The exercise program was performed for 1 h at a time, once a week, for 12 weeks. Study parameters were evaluated at baseline and 3 months after baseline evaluation. Results Combined aerobic and resistance exercise better controlled the body mass index (BMI), and also improved maximum muscular strength and maximum exercise intensity. On psychological tests, subjects’ attention and quality of life showed improving tendency, while their stress and behavioral problems diminished. The number of exercise events increased in the training group, while the daily total insulin dose and glycated hemoglobin (HbA1c) level showed no significant changes. Conclusions A 12-week structured exercise program consisting of aerobic and resistance exercises improves cardiovascular, neurocognitive and psychobehavioral functions, and positively helps lifestyle modification in patients with T1DM.


2015 ◽  
Vol 50 (2) ◽  
pp. 117-125 ◽  
Author(s):  
François Fourchet ◽  
Luke Kelly ◽  
Cosmin Horobeanu ◽  
Heiko Loepelt ◽  
Redha Taiar ◽  
...  

Context: Fatigue-induced alterations in foot mechanics may lead to structural overload and injury. Objectives: To investigate how a high-intensity running exercise to exhaustion modifies ankle plantar-flexor and dorsiflexor strength and fatigability, as well as plantar-pressure distribution in adolescent runners. Design: Controlled laboratory study. Setting: Academy research laboratory. Patients or Other Participants: Eleven male adolescent distance runners (age = 16.9 ± 2.0 years, height = 170.6 ± 10.9 cm, mass = 54.6 ± 8.6 kg) were tested. Intervention(s): All participants performed an exhausting run on a treadmill. An isokinetic plantar-flexor and dorsiflexor maximal-strength test and a fatigue test were performed before and after the exhausting run. Plantar-pressure distribution was assessed at the beginning and end of the exhausting run. Main Outcome Measure(s): We recorded plantar-flexor and dorsiflexor peak torques and calculated the fatigue index. Plantar-pressure measurements were recorded 1 minute after the start of the run and before exhaustion. Plantar variables (ie, mean area, contact time, mean pressure, relative load) were determined for 9 selected regions. Results: Isokinetic peak torques were similar before and after the run in both muscle groups, whereas the fatigue index increased in plantar flexion (28.1%; P = .01) but not in dorsiflexion. For the whole foot, mean pressure decreased from 1 minute to the end (−3.4%; P = .003); however, mean area (9.5%; P = .005) and relative load (7.2%; P = .009) increased under the medial midfoot, and contact time increased under the central forefoot (8.3%; P = .01) and the lesser toes (8.9%; P = .008). Conclusions: Fatigue resistance in the plantar flexors declined after a high-intensity running bout performed by adolescent male distance runners. This phenomenon was associated with increased loading under the medial arch in the fatigued state but without any excessive pronation.


2001 ◽  
Vol 22 (8) ◽  
pp. 662-665 ◽  
Author(s):  
Ulunay Kanatli ◽  
Haluk Yetkin ◽  
Aykin Simsek ◽  
Koksal Besli ◽  
Akif Ozturk

Loss of heel pad elasticity has been suggested as one of the possible explanations of heel pain. This study aimed to determine the effect of heel pad thickness and its compressibility to heel pressure distribution, in 47 (94 feet) normal subjects and 59 (94 feet) patients with heel pain, using radiological measurements and EMED-SF (Novel, Munich) plantar pressure distribution measurement system. Both heels of the patients and control group were radiographed with and without weight bearing. The ratio of the heel pad thickness in loading to unloading position was defined as “the heel pad compressibility index.” The plantar peak pressure of the heel was measured at heel strike phase of the gait cycle. The compressibility index for control and patient groups were found to be 0.60 and 0.69, respectively. The peak pressure under the heel pad was recorded to be 28.4 N/cm2 for patients and 31.7 N/cm2 for control group. No significant difference was found for heel pad compressibility index and heel pad pressures between patient and control groups (p>0.05). This study revealed that there is no relationship between heel pad compressibility and pressure distribution of the heel pad both in control and patient group. We feel the flexibility of the heel pad does not have any influence on heel pain syndromes.


Author(s):  
Miura M ◽  
◽  
Nagai K ◽  
Tagomori K ◽  
Ikutomo H ◽  
...  

Introduction: Assessment of plantar pressure indicates the manner in which the plantar region contacts the ground as the first point in a leg-linked kinetic chain, and receives force from the ground. However, few studies have examined the changes in plantar pressure distribution in patients who underwent Total Hip Arthroplasty (THA) before and after THA, or compared plantar pressure distribution between THA patients and healthy adults. Objective: Plantar pressure distribution in patients with end-stage hip osteoarthritis who undergo THA may be adjusted to that in healthy adults by correcting leg length discrepancy. Herein, our objective was to find out if the plantar pressure distribution during standing differs before and after THA, and between healthy adults and THA patients. Design: Case control study. Setting: Single orthopedic clinic in Japan. Participants: THA patients (n=58; THA group) and healthy adults (n=53; control group). Interventions: Not applicable. Main outcome measure(s): The maximum plantar pressure under each foot measured during standing for 20 s was assessed for location, symmetry, and leg length discrepancy. Results: The distribution plantar pressure in the THA group differed preand postoperatively. The maximum plantar pressure region was the heel in approximately 80% of the patients three months after THA; it was not different in THA patients three months postoperatively and in healthy adults. Patients with asymmetrical maximum plantar pressure regions were those whose postoperative maximum plantar pressure region in the affected leg was the forefoot and those whose maximum plantar pressure region in the affected leg shifted to the heel. The leg length discrepancies decreased significantly after THA. Conclusions: The plantar pressure distribution during standing in female patients adjusted to that in healthy adults after THA. Patients with asymmetrical distribution of maximum plantar pressure may benefit from balance assessment and physical therapy.


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