Does the thickening of Achilles tendon and plantar fascia contribute to the alteration of diabetic foot loading?

Giacomozzi, Claudia; D’Ambrogi, Emanuela; Uccioli, Luigi; Macellari, Velio

doi:10.1016/j.clinbiomech.2005.01.011

Cited by 138 publications

(201 citation statements)

References 28 publications

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“…This conversely refutes those other studies that attribute this condition with increased pressure (20)(21)(22).…”

Section: Discussionsupporting

confidence: 88%

“…According to a series of studies performed by D'Ambrogi and colleagues, plantar fasciitis causes the fascia to thicken which in turn increases stiffness of the medial longitudinal arch resulting in an increase in plantar pressures during gait. However, this relationship was seen in diabetic participants, which made the authors speculate as to whether the increase in pressure had a systemic or a mechanical origin (20)(21)(22).…”

Section: Introductionmentioning

confidence: 97%

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The Relationship between Plantar Fasciitis and Plantar Heel Pressure

2017

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Objective: The presence of increased medial heel plantar pressure in plantar fasciitis has been debated, with clinicians often utilizing pressure-relieving devices, such as heel pads and cups, as a means of management. Method: Plantar pressures in a sample of 15 adult participants with chronic plantar fasciitis were compared to plantar pressures of the 15 adult participants forming the control group, who were matched for age, gender and weight. Results: There were no significant differences in peak heel plantar pressure (p = 0.244), lateral peakplantar pressure (p = 0.876), forefoot peak plantar pressure (p = 0.576) and the Forefoot to Rearfoot peak pressure ratio (p = 0.242) between the 2 groups. However, there was a significant difference (p = 0.015) in medial heel peak plantar pressure between the 2 groups, with the plantar fasciitis group having lower medial heel pressure than the control group. Conclusion: The findings in this study suggest that there is no relationship between peak medial heel plantar pressures and chronic medioplantar heel pain in plantar fascitis. There is also no shift in pressure from the symptomatic medio-plantar heel region to the latero-plantar heel and forefoot regions. As a result, pressure may not play a part in the pathophysiology of plantar fascitis.Key Words: plantar fasciitis; plantar pressure; heel pain. ResumenObjetivos: La presencia de incremento de presión plantar en la zona medial del talón en la fascitis plantar ha sido estudiado, y los clínicos a menudo utilizan dispositivos de alivio de la presión, como almohadillas de talón y cazoletas, como medio de manejo. Método: Las presiones plantares en una muestra de 15 participantes adultos con fascitis plantar crónica se compararon con las presiones plantares de los 15 participantes adultos que formaron el grupo control, que fueron comparados por edad, sexo y peso. Resultados: No hubo diferencias significativas en la presión plantar en el pico pico (p = 0,244), en la presión pico lateral (p = 0,876), en la presión plantar pico en el antepié (p = 0,576) Los 2 grupos. Sin embargo, hubo una diferencia significativa (p = 0,015) en la presión plantar del talón medial entre los 2 grupos, con el grupo de fascitis plantar con menor presión en el talón medial que en el grupo control. Conclusión: Los hallazgos en este estudio sugieren que no hay relación entre el pico medial del talón de las presiones plantares y crónico medio-plantar talón dolor en la fascitis plantar. Tampoco hay cambio en la presión de la región sintomática del talón medio-plantar a las regiones del talón latero-plantar y del antepié. Como resultado, la presión puede no desempeñar un papel en la fisiopatología de la fascitis plantar.Palabras Clave: fascitis plantar; presión plantar; dolor de talón.

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“…This conversely refutes those other studies that attribute this condition with increased pressure (20)(21)(22).…”

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 97%

The Relationship between Plantar Fasciitis and Plantar Heel Pressure

2017

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“…Decreases in first metatarsal and forefoot motion accentuate the finding that it takes less supination in the foot with DM to create a stable, rigid lever at push off. In subjects with DM, a greater proportion of midfoot stability may be derived from modified/ stiffer soft tissue such as the plantar fascia [53].…”

Section: Discussionmentioning

confidence: 99%

Segmental foot mobility in individuals with and without diabetes and neuropathy

Rao

Saltzman

Yack

2007

Clinical Biomechanics

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“…Limited joint mobility in the hands has been previously described as an index of tissue glycation, but its prevalence has fallen significantly in the past two decades (8). Ultrasound has recently been used to detect thickening of the plantar aponeurosis, a tissue rich in collagen and susceptible to nonenzymatic glycation, in adults with type 1 and type 2 diabetes (9,10). We have previously demonstrated that increased plantar fascia thickness (PFT) was present in one-third of adolescents with type 1 diabetes compared with nondiabetic control subjects, whereas limited passive extension of the interphalangeal joints of the hands was present in 13% (11).…”

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confidence: 99%

Plantar Fascia Thickness, a Measure of Tissue Glycation, Predicts the Development of Complications in Adolescents With Type 1 Diabetes

et al. 2008

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OBJECTIVE -Direct measurement of collagen glycation requires skin biopsy, which is invasive. We hypothesized that measurement of plantar fascia thickness (PFT) by ultrasound is an alternative index of tissue glycation and a marker of microvascular disease.RESEARCH DESIGN AND METHODS -This was a prospective longitudinal study of microvascular complications in 344 adolescents with type 1 diabetes, whose PFT was assessed by ultrasound at baseline. Retinopathy was assessed by seven-field fundal photography, albumin excretion rate (AER) measured from three consecutive timed overnight urine specimens, autonomic neuropathy by pupillometry and cardiovascular tests, and peripheral neuropathy by vibration and thermal thresholds. Longitudinal analysis was performed using generalized estimating equations with baseline PFT, duration, and A1C as explanatory variables.RESULTS -At first assessment, median (interquartile range) age was 15.1 (13.5-17.2) years and diabetes duration was 8.5 (6.0 -11.5) years. Median follow up was 3.2 (2.1-4.5) years with a median of 4 (2-13) complications assessments per patient. In multivariate analysis, baseline PFT (abnormal in 132 subjects, 38%) predicted subsequent development of retinopathy (odds ratio 2. CONCLUSIONS -PFT is a significant predictor of the subsequent development of complications in type 1 diabetes, suggesting that glycation and oxidation of collagen in soft tissues may be independent risk factors for microvascular complications.

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Does the thickening of Achilles tendon and plantar fascia contribute to the alteration of diabetic foot loading?

Cited by 138 publications

References 28 publications

The Relationship between Plantar Fasciitis and Plantar Heel Pressure

The Relationship between Plantar Fasciitis and Plantar Heel Pressure

Segmental foot mobility in individuals with and without diabetes and neuropathy

Plantar Fascia Thickness, a Measure of Tissue Glycation, Predicts the Development of Complications in Adolescents With Type 1 Diabetes

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