TY - JOUR
T1 - Alterations to plantar loading and ankle range of motion of the contralateral foot during assisted walking in patients with Type 2 Diabetes Mellitus
AU - Anguiano-Hernandez, Jose G.
AU - Harrington, Joseph W.
AU - Shivaswamy, Vijay
AU - Kingston, David C.
N1 - Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/10
Y1 - 2022/10
N2 - Aims: Patients with diabetic foot ulcers are instructed to be non-weight bearing on the affected limb to promote healing. Therefore, the aim of this study was to investigate the effect of different assistive devices on whole foot plantar loading, peak forefoot force, ankle range of motion, and locomotion speed during gait in patients with Type 2 Diabetes Mellitus. Methods: Participants walked normally, with crutches, a walker, and a wheeled knee walker (WKW) in randomized order. Force sensitive insoles and 3D motion capture were used to record plantar normal force and ankle kinematics. Force sensitive pads were wrapped around handles of the crutches and walker to measure bodyweight offloaded onto the assistive device. An instrumented WKW was used to measure bodyweight offloaded onto the handlebars and knee cushion. Results: Locomotion with the WKW produced the lowest whole foot plantar loading and peak forefoot force in the propulsive limb, while also producing the greatest ankle range of motion and locomotion speed amongst assistive devices. Conclusions: This pre-clinical study found that the WKW could be the preferred assistive device for total unilateral offloading of diabetic foot ulcers as it reduced propulsive limb whole foot and forefoot plantar loading while retaining ankle range of motion and locomotion speed.
AB - Aims: Patients with diabetic foot ulcers are instructed to be non-weight bearing on the affected limb to promote healing. Therefore, the aim of this study was to investigate the effect of different assistive devices on whole foot plantar loading, peak forefoot force, ankle range of motion, and locomotion speed during gait in patients with Type 2 Diabetes Mellitus. Methods: Participants walked normally, with crutches, a walker, and a wheeled knee walker (WKW) in randomized order. Force sensitive insoles and 3D motion capture were used to record plantar normal force and ankle kinematics. Force sensitive pads were wrapped around handles of the crutches and walker to measure bodyweight offloaded onto the assistive device. An instrumented WKW was used to measure bodyweight offloaded onto the handlebars and knee cushion. Results: Locomotion with the WKW produced the lowest whole foot plantar loading and peak forefoot force in the propulsive limb, while also producing the greatest ankle range of motion and locomotion speed amongst assistive devices. Conclusions: This pre-clinical study found that the WKW could be the preferred assistive device for total unilateral offloading of diabetic foot ulcers as it reduced propulsive limb whole foot and forefoot plantar loading while retaining ankle range of motion and locomotion speed.
KW - Ankle kinematics
KW - Assistive devices
KW - Diabetic foot ulcers
KW - Hand force
KW - Plantar force
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U2 - 10.1016/j.gaitpost.2022.08.018
DO - 10.1016/j.gaitpost.2022.08.018
M3 - Article
C2 - 36055183
AN - SCOPUS:85138512403
SN - 0966-6362
VL - 98
SP - 56
EP - 61
JO - Gait and Posture
JF - Gait and Posture
ER -