Association of limited joint mobility and high plantar pressure in diabetic foot ulceration in Asian Indians

Aim: To investigate the association of limited joint mobility (LJM) and plantar foot pressure in Asian Indian diabetic subjects. Subjects and methods: The LIM and plantar pressure were measured in 345 consecutive subjects attending the foot clinic. The study groups were: Control-non-diabetic controls (n = 50), DM-diabetic patients without neuropathy (n = 100), DM + N-diabetic neuropaths (n = 110) and DM + NU-diabetic neuropaths with past history of foot ulceration (n = 85). Joint mobility was assessed using a goniometer. Plantar pressure was measured using the RS-Scan platform system. All subjects were able to walk comfortably unaided at their own pace. Data obtained on the metatarsal heads were used for analysis. Neuropathy status was assessed using the biothesiometer. Results: The diabetic patients had higher prevalence of LJM and higher plantar pressure than control subjects (P < 0.0001). Among the diabetic patients, those with neuropathy and history of plantar ulceration had higher LJM and plantar pressure compared to non-neuropaths (P < 0.001). Conclusions: Both LJM and high plantar pressure appear to be important determinants of foot ulceration in susceptible neuropathic South Indian diabetic patients. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.