Nöropatisi Olan Tip 2 Diyabetli Bireylerde Plantar Fleksör Sertliği ile Plantar Basınç Arasındaki İlişkinin İncelenmesi
I.S.P.O. 20th World Congress 2025, Stockholm, İsveç, 16 - 19 Haziran 2025, ss.413, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Doi Numarası: 10.82017/ispo2025.abstractbook
- Basıldığı Şehir: Stockholm
- Basıldığı Ülke: İsveç
- Sayfa Sayıları: ss.413
- İstanbul Medipol Üniversitesi Adresli: Evet
Özet
BACKGROUND
In Type 2 Diabetes Mellitus (T2DM), peripheral neuropathy is a significant risk factor for amputation.1 Due to impaired autonomic regulation and non-enzymatic glycosylation, the flexibility of the foot and ankle joints decreases.2 Increased stiffness in soft tissues impairs the foot’s rocker functions, leading to elevated plantar pressure.3 While reduced ankle mobility is known to negatively affect plantar pressure, the relationship between stiffness of the plantar flexors and plantar pressure distribution remains unclear.
AIM
We aimed to investigate the relationship between plantar flexor stiffness and plantar pressure distribution in T2DM with neuropathy.
METHOD
A total of 48 individuals with peripheral neuropathy associated with T2DM were included in the study. Neuropathy was assessed using a biothesiometer. Plantar pressure distribution during gait was evaluated using a pedobarograph platform, recording peak pressure (N/cm²) in 10 regions of the foot and the forefoot/rearfoot pressure ratio. Plantar flexor stiffness was assessed using an isokinetic dynamometer set at 60°/s in passive movement mode, calculated as the force applied to dorsiflexion divided by the degree of movement. The relationship between plantar stiffness, plantar pressure, and neuropathy values was analyzed using Pearson's correlation test.
RESULTS
The study included 48 individuals with a mean age of 59.0 ± 2.4 years and a body mass index of 28.8 ± 1.9 kg/cm². A significant positive correlation was found between plantar flexor stiffness and the peak pressure under the 2nd metatarsal head (r=0.383, p=0.007), the 3rd metatarsal head (r=0.372, p=0.009), and the forefoot/rearfoot plantar pressure ratio (r=0.653, p<0.01). Additionally, a significant positive correlation was found between the average plantar neuropathy value and the peak pressure under the 2nd metatarsal head (r=0.316, p=0.028). No significant correlations were observed between stiffness and disease duration, HbA1c levels, or neuropathy values (p>0.05).
DISCUSSION AND CONCLUSION
Increased plantar flexor stiffness in individuals with T2DM and neuropathy is associated with higher plantar pressure under the 2nd and 3rd metatarsal heads and an imbalance in forefoot-rearfoot plantar pressure distribution. To reduce pressure in the metatarsal heads, which are high-risk areas for diabetic foot ulcers, preventive strategies should include exercises and orthotic interventions aimed at reducing plantar flexor stiffness as part of the treatment program.