Induration of the Diabetic Foot Pad: Another Risk Factor for Recurrent Neuropathic Plantar Ulcers - Verhärtung der diabetischen Fußsohle - eine Prädisposition für rezidivierende neuropathische Fußgeschwüre

Brink, T

doi:10.1515/bmte.1995.40.7-8.205

Cited by 31 publications

(11 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…80% of studies (16/20) utilised US‐based measures [39–43, 45, 46, 49, 50, 52, 53, 55, 58–61], while the following instruments were used by one study each: CT [57], MRI [37], optical coherence tomography [36] and spiral X‐ray CT [56]. Of US‐based studies, 50% (8/16) utilised US alone [39, 43, 45, 50, 52, 59–61], 25% utilised TUPS [41, 42, 45, 55], 25% combined use of US with either a load cell or indentation system [46, 49, 53, 58] and one study utilised an US connected with a dynamometer [40]. Chao et al (2011) [45] was the only study to utilise two different techniques in their assessment: US for the epidermis only and TUPS for total PTT.…”

Section: Resultsmentioning

confidence: 99%

“…Chao et al (2011) [45] was the only study to utilise two different techniques in their assessment: US for the epidermis only and TUPS for total PTT. 63% of studies (10/16) utilised B‐mode US [39, 40, 43, 45, 46, 49, 52, 55, 60, 61], 19% utilised M‐mode US [42, 45, 49], 13% utilised A‐mode US [45, 50] and 19% did not specify the US modality utilised [41, 58, 59]; Chao et al (2011) [45] and Hsu et al (2007) [49] used more than one US modality.…”

Section: Resultsmentioning

confidence: 99%

“…From 19 papers assessing PTS, six different assessment tools were used. 47% of studies (9/19) utilised US‐based measures [40–42, 45, 46, 53, 55, 58, 62], 26% utilised the durometer [44, 51, 52, 59, 64], 11% utilised cutometer [36, 50], and the following instruments were used by one study each: indentor system [63], subject‐specific finite element model [34] and spiral X‐ray CT [56]. Of US‐based studies, 44% (4/9) utilised TUPS [41, 42, 45, 55], 22% combined use of the US with either an indentation system or load cell [46, 58], and one study each utilised: US alone [53], US connected with a dynamometer [40] and magnetic resonance elastography [62].…”

Section: Resultsmentioning

confidence: 99%

“…Plantar tissue thickness PTT was measured as the distance between skin and bone in 70% of studies (14/20) [37,41,42,45,46,49,52,53,[55][56][57][58][59][60]. A slight variation in measurement was noted in one study, with the authors measuring PTT as the distance between probe and bone instead [40].…”

Section: Methods Of Measurementmentioning

confidence: 99%

“…The only study investigating ATS found stiffness to be significantly lower in people with active DFUs when compared with people with Type 2 diabetes and healthy controls at the distal (insertional) and mid-portion only; no significant differences were found between groups at the proximal segment (myotendinous junction) [38]. Brink (1995) [59] and Thomas et al (2003) [52] were the only two studies to directly compare their findings for either active or healed DFU sites with non-ulcerated sites. Both studies found PTS at DFU sites to be increased when compared to non-ulcerated sites.…”

Section: Participantsmentioning

confidence: 99%

See 4 more Smart Citations

Plantar soft tissues and Achilles tendon thickness and stiffness in people with diabetes: a systematic review

Khor

Woodburn

Newcombe

et al. 2021

Journal of Foot and Ankle Research

View full text Add to dashboard Cite

Background Diabetes mellitus is associated with changes in soft tissue structure and function. However, the directionality of this change and the extent to which either tissue thickness or stiffness contributes to the pathogenesis of diabetes-related foot ulcerations is unclear. Hence, this systematic review aims to summarise the existing evidence for soft tissue structural differences in the feet of people with and without diabetes. Methods In compliance with MOOSE and PRISMA guidelines, AMED, CINAHL, MEDLINE, ProQuest Health & Medical Collection, ProQuest Nursing & Allied Health Database, and Web of Science electronic databases were systematically searched for studies published from database inception until 1st October 2020 [Prospero CRD42020166614]. Reference lists of included studies were further screened. Methodological quality was appraised using a modified critical appraisal tool for quantitative studies developed by McMaster University. Results A total of 35 non-randomised observational studies were suitable for inclusion. Within these, 20 studies evaluated plantar tissue thickness, 19 studies evaluated plantar tissue stiffness, 9 studies evaluated Achilles tendon thickness and 5 studies evaluated Achilles tendon stiffness outcomes. No significant differences in plantar tissue thickness were found between people with and without diabetes in 55% of studies (11/20), while significantly increased plantar tissue stiffness was found in people with diabetes in 47% of studies (9/19). Significantly increased Achilles tendon thickness was found in people with diabetes in 44% of studies (4/9), while no significant differences in Achilles tendon stiffness were found between people with and without diabetes in 60% of studies (3/5). Conclusions This systematic review found some evidence of soft tissue structural differences between people with and without diabetes. However, uncertainty remains whether these differences independently contribute to diabetes-related foot ulcerations. The heterogeneity of methodological approaches made it difficult to compare across studies and methodological quality was generally inadequate. High-quality studies using standardised and validated assessment techniques in well-defined populations are required to determine more fully the role of structural tissue properties in the pathogenesis of diabetes-related foot ulcerations.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methods Of Measurementmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

See 3 more Smart Citations

Plantar soft tissues and Achilles tendon thickness and stiffness in people with diabetes: a systematic review

Khor

Woodburn

Newcombe

et al. 2021

Journal of Foot and Ankle Research

View full text Add to dashboard Cite

show abstract

Foot fat pad: Characterization by mesenchymal stromal cells in rats

Zhang

Paudel

Feltham

et al. 2020

The Anatomical Record

View full text Add to dashboard Cite

Foot fat pad (FFP) is a highly functionalized fat depot of great significance for weight bearing in the foot. Mesenchymal stromal cells (MSCs) in subcutaneous adipose tissues are widely studied for regenerative potentials. MSCs in FFP, which may contribute to the physiological and pathological conditions of the foot, have not been characterized. In this study, MSCs were isolated from FFP (designated as MSCs-ffp) and subcutaneous adipose tissue (designated as MSCs-sub) from rats. The cell surface markers, proliferation, and efficiency of colony formation were compared between MSCs-ffp and MSCs-sub. In addition, MSCs-ffp were induced for osteogenic, chondrogenic, and adipogenic differentiation. The tri-lineage differentiation potentials were compared between MSCs-ffp and MSCs-sub by the expression of Runx2, Sox9, and proliferatoractivated receptor gamma (PPAR-γ), respectively, using quantitative polymerized chain reaction. The expression of elastin and associated genes by MSCsffp were also evaluated. MSCs-ffp, like MSCs-sub, expressed CD44, CD73, and CD90. MSCs-ffp and MSCs-sub proliferated at similar rates but MSCs-ffp formed more colonies than MSCs-sub. MSCs-ffp were capable of differentiating into osteogenic, chondrogenic, and adipogenic lineages. Under the conditions of osteogenic and adipogenic differentiation, MSCs-sub expressed more Runx2 and PPAR-γ, respectively, than MSCs-ffp. The undifferentiated MSCs-ffp upregulated the expression of fibulin-5. In conclusion, MSCs-ffp shared common biology with MSCs-sub but were more efficient in colony formation, less adipogenic and osteogenic, and participated in elastogenesis. The unique features of MSCs-ffp may relate to their roles in the physiological functions of FFP. K E Y W O R D S adipose tissue, foot fat pad, mesenchymal stromal cell 1 | INTRODUCTION Adipose tissue is among the most abundant in the body and principally serves to store and release energy (Tchkonia et al., 2013). According to the functions of adipocytes, adipose tissues are classified into two categories: (a) white adipose tissue, which stores and mobilizes energy in the form of triglycerides; (b) brown adipose tissue, which mainly functions in thermogenesis (Giralt &

show abstract

Ultrasonographic measurement of the mechanical properties of the sole under the metatarsal heads

Wang

Hsu

Shau

et al. 1999

Journal Orthopaedic Research

View full text Add to dashboard Cite

The sole under the metatarsal heads functions as a shock absorber during walking and running. The mechanical properties of the sole provide the primary defense against the development of metatarsalgia and foot ulceration. However, limited information about these properties has been documented. In this study, we used ultrasonography to evaluate the mechanical properties, including unloaded thickness, compressibility index, elastic modulus, and energy dissipation ratio, of the sole in 20 healthy subjects. The unloaded thickness decreased progressively from the first to the fifth metatarsal heads, with values of 1.50, 1.36, 1.25, 1.14, and 1.04 cm. The sole under the first metatarsal head had the greatest values for the compressibility index and elastic modulus (55.9% and 1.39 kg/cm2), and the sole under the third metatarsal head had the smallest values (50.8% and 1.23 kg/cm2). The sole under the fifth metatarsal head had the greatest energy dissipation ratio (33.7%), followed by that under the third, second, first, and fourth metatarsal heads. Multivariate adjusted linear regression showed that the unloaded thickness, compressibility index, and elastic modulus values increased significantly with age and body weight (p < 0.05) and that the energy dissipation ratio increased significantly with body weight (p < 0.05)

show abstract

Induration of the Diabetic Foot Pad: Another Risk Factor for Recurrent Neuropathic Plantar Ulcers - Verhärtung der diabetischen Fußsohle - eine Prädisposition für rezidivierende neuropathische Fußgeschwüre

Cited by 31 publications

References 12 publications

Plantar soft tissues and Achilles tendon thickness and stiffness in people with diabetes: a systematic review

Plantar soft tissues and Achilles tendon thickness and stiffness in people with diabetes: a systematic review

Foot fat pad: Characterization by mesenchymal stromal cells in rats

Ultrasonographic measurement of the mechanical properties of the sole under the metatarsal heads

Contact Info

Product

Resources

About