Lower limb biomechanical characteristics of patients with neuropathic diabetic foot ulcers: the diabetes foot ulcer study protocol

BMC Endocrine Disorders

Jonathan Golledge⁴  Kunwarjit Singh Sangla⁵  Peter Anthony Lazzarini²  Margaret Cunningham⁶  Robert George Crowther³  Malindu Eranga Fernando¹ 

[1] Podiatry Service, Kirwan Community Health Campus, Townsville, QLD, Australia;School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia;Sport and Exercise, School of Health and Wellbeing, University of Southern Queensland, Brisbane, Australia;Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Australia;Department of Internal Medicine, The Townsville Hospital, Townsville, Australia;Department of Health Sciences, University of Stirling, Stirling, Scotland, UK

关键词: Plantar pressure;    Protocols;    Gait;    Longitudinal studies;    Foot ulcer;    Diabetic foot;    Diabetic neuropathies;   

Others  :  1230193
DOI  :  10.1186/s12902-015-0057-7

 received in 2015-08-28, accepted in 2015-10-15,  发布年份 2015

【 摘 要 】

Background

Foot ulceration is the main precursor to lower limb amputation in patients with type 2 diabetes worldwide. Biomechanical factors have been implicated in the development of foot ulceration; however the association of these factors to ulcer healing remains less clear. It may be hypothesised that abnormalities in temporal spatial parameters (stride to stride measurements), kinematics (joint movements), kinetics (forces on the lower limb) and plantar pressures (pressure placed on the foot during walking) contribute to foot ulcer healing. The primary aim of this study is to establish the biomechanical characteristics (temporal spatial parameters, kinematics, kinetics and plantar pressures) of patients with plantar neuropathic foot ulcers compared to controls without a history of foot ulcers. The secondary aim is to assess the same biomechanical characteristics in patients with foot ulcers and controls over-time to assess whether these characteristics remain the same or change throughout ulcer healing.

Methods/Design

The design is a case–control study nested in a six-month longitudinal study. Cases will be participants with active plantar neuropathic foot ulcers (DFU group). Controls will consist of patients with type 2 diabetes (DMC group) and healthy participants (HC group) with no history of foot ulceration. Standardised gait and plantar pressure protocols will be used to collect biomechanical data at baseline, three and six months. Descriptive variables and primary and secondary outcome variables will be compared between the three groups at baseline and follow-up.

Discussion

It is anticipated that the findings from this longitudinal study will provide important information regarding the biomechanical characteristic of type 2 diabetes patients with neuropathic foot ulcers. We hypothesise that people with foot ulcers will demonstrate a significantly compromised gait pattern (reduced temporal spatial parameters, kinematics and kinetics) at base line and then throughout the follow-up period compared to controls. The study may provide evidence for the design of gait-retraining, neuro-muscular conditioning and other approaches to off-load the limbs of those with foot ulcers in order to reduce the mechanical loading on the foot during gait and promote ulcer healing.

【 授权许可】

   
2015 Fernando et al.

【 图 表 】

Figure 8.

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