Research Article
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Plantar Pain, Balance and Foot Functions in Individuals with Diabetes Mellitus

Year 2024, Volume: 13 Issue: 1, 1 - 10, 20.03.2024

Mehmet Duray Nilüfer Çetişli Korkmaz Buse Kılınç Semin Melahat Fenkçi

https://doi.org/10.53424/balikesirsbd.1233393

Abstract

Aim: The aim of this study was to investigate the relationship between plantar pain, balance and foot function in Diabetes Mellitus (DM) patients with obese and non-obese. Material and Methods: Fifty-four patients were diagnosed as DM were included. Participants were seperated as non-obese (n=27) and obese (n=27). The balance abilities (dynamic and static balance) of participants were examined with the Portable Computerized Kinesthetic Ability Trainer (SportKAT-550). Pain, disability and function status of foot were assessed according to Foot Function Index (FFI) and Manchester Foot Pain and Disability Index (MFPDI). Results: FFI-Disability and MFPDI scores of the Non-Obese.Group were significantly better than Obese Group. While there were no significant correlation between BMI and MFPDI, FFI-Activity.Limitation and FFI-Disability scores in both groups (p>0.05), there was medium and positive significant correlation just between BMI and FFI-Pain.in.Non-Obese Group (p<0.05). FFI-Pain scores showed a positive and medium/high relationship with MFPDI, FFI-Activity Limitation and FFI-Disability scores in both groups (p<0.05). Conclusion: The increased BMI in obese individuals with DM is possible reason of increased plantar pain, which seems to be the primary cause of dysfunction of the foot. BMI has a direct negative effect on sufficiency and disability and an indirect effect on activity limitation and reduced participation rate in individuals with DM.

Keywords

Balance Body Mass Index Diabetes Mellitus Function Plantar Pain

Supporting Institution

TÜBİTAK

Project Number

1919B011703063

Thanks

The authors thank all participants who participated in this work. Special thanks to physiotherapist Sevgi İNTİŞAH, Mehmet Akif SILAY and Hanife Nur YÜCEL for their kind assistance in collecting the data from participants. For the expenses of Sevgi İNTİŞAH, Mehmet Akif SILAY and Hanife Nur YÜCEL, a total of 2500 TL was received from TÜBİTAK-BIDEB - 2017/2 -1919B011703063.

References

  • Awale, A., Hagedorn, T. J., Dufour, A. B., Menz, H. B., Casey, V. A., & Hannan, M. T. (2017). Foot function, foot pain, and falls in older adults: the Framingham foot study. Gerontology, 63(4), 318-324. https://doi.org/10.1159/000475710.
  • Barnes, A., Sullivan, J., Pappas, E., Adams, R., & Burns, J. (2017). Clinical and functional characteristics of people with chronic and recent‐onset plantar heel pain The Journal of Injury, Function and Rehabilitation, 9(11), 1128-1134. https://doi.org/1 0.1016/j.pmrj.2017.04.009.
  • Chatterton, B. D., Muller, S., & Roddy, E. (2015). Epidemiology of posterior heel pain in the general population: Cross‐sectional findings from the clinical assessment study of the foot. Arthritis Care & Research, 67(7), 996-1003. https:// doi.org/10.1002/acr.22546.
  • Cheing, G. L., Chau, R. M., Kwan, R. L., Choi, C. H., & Zheng, Y. P. (2013). Do the biomechanical properties of the ankle–foot complex influence postural control for people with Type 2 diabetes?. Clinical Biomechanics, 28(1), 88-92. https://doi.org/10.1016/j.clinbiomech.2012.09.001.
  • Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., ... & Tate, D. F. (2016). Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079. https://doi.org/10.2337/dc16-1728.
  • Duffin, A. C., Lam, A., Kidd, R., Chan, A. K. F., & Donaghue, K. C. (2002). Ultrasonography of plantar soft tissues thickness in young people with diabetes. Diabetic Medicine, 19(12), 1009-1013. https://doi.org/10.10 46/j.1464-5491.2002.00850.x.
  • Frames, C. W., Soangra, R., Lockhart, T. E., Lach, J., Ha, D. S., Roberto, K. A., & Lieberman, A. (2018). Dynamical properties of postural control in obese community-dwelling older adults. Sensors, 18(6), 1692. https://doi.org/10.3390/s18061692.
  • Garrow, A. P., Papageorgiou, A. C., Silman, A. J., Thomas, E., Jayson, M. I., & Macfarlane, G. J. (2000). Development and validation of a questionnaire to assess disabling foot pain. Pain, 85(1-2), 107-113. https://doi.org/10.1016/S0304-3959(99)00263-8.
  • Giacomozzi, C., D’ambrogi, E., Uccioli, L., & Macellari, V. (2005). Does the thickening of Achilles tendon and plantar fascia contribute to the alteration of diabetic foot loading?. Clinical Biomechanics, 20(5), 532-539. https://doi.org/10.1016/j.clinbiomech.2005.0 1.011.
  • Gomes, A. A., Ackermann, M., Ferreira, J. P., Orselli, M. I. V., & Sacco, I. C. (2017). Muscle force distribution of the lower limbs during walking in diabetic individuals with and without polyneuropathy. Journal Of Neuroengineering And Rehabilitation, 14(1), 1-13. https://doi.org/10.1186/s12984-017-0327-x.
  • Hansen, M. S., Dieckmann, B., Jensen, K., & Jakobsen, B. W. (2000). The reliability of balance tests performed on the kinesthetic ability trainer (KAT 2000). Knee Surgery, Sports Traumatology, Arthroscopy, 8(3), 180-185. https://doi.org/10.1007/s001670050211.
  • Hazari, A., Maiya, A. G., Shivashankara, K. N., Agouris, I., Monteiro, A., Jadhav, R., ... & Mayya, S. S. (2016). Kinetics and kinematics of diabetic foot in type 2 diabetes mellitus with and without peripheral neuropathy: a systematic review and meta-analysis. Springerplus, 5(1), 1-19. https://doi.org/10.1186/s40 064-016-3405-9.
  • Kera, T., Kawai, H., Hirano, H., Kojima, M., Watanabe, Y., Fujiwara, Y., ... & Obuchi, S. (2018). Comparison of body composition and physical and cognitive function between older Japanese adults with no diabetes, prediabetes and diabetes: a cross‐sectional study in community‐dwelling Japanese older people. Geriatrics & Gerontology International, 18(7), 1031-1037. https://doi.org/10.1111/ggi.13301.
  • Külünkoğlu, B., Firat, N., Yildiz, N. T., & Alkan, A. (2018). Reliability and validity of the Turkish version of the Foot Function Index in patients with foot disorders. Turkish Journal of Medical Sciences, 48(3), 476-483. https://doi.org/10.3906/sag-1705-143.
  • Lim, K. B., Kim, D. J., Noh, J. H., Yoo, J., & Moon, J. W. (2014). Comparison of balance ability between patients with type 2 diabetes and with and without peripheral neuropathy. Archives of Physical Medicine and Rehabilitation, 6(3), 209-214. https://doi.org/10.1016/j.pmrj.2013.11.007.
  • Matos, M., Mendes, R., Silva, A. B., & Sousa, N. (2018). Physical activity and exercise on diabetic foot related outcomes: A systematic review. Diabetes Research and Clinical Practice, 139, 81-90. https://doi.org/10.1016/j.diabres.2018.02.020.
  • Menz, H. B., Munteanu, S. E., Zammit, G. V., & Landorf, K. B. (2010). Foot structure and function in older people with radiographic osteoarthritis of the medial midfoot. Osteoarthritis and Cartilage, 18(3), 317-322. https://doi.org/10.1016/j.joca.200 9.11.010.
  • Mickle, K. J., & Steele, J. R. (2015). Obese older adults suffer foot pain and foot-related functional limitation. Gait & Posture, 42(4), 442-447. https://doi.org/10.1016/j.gaitpost.2015.07.013.
  • Moes, J. (2019). Proper fitting shoes: reducing pain, increasing activity, and improving foot health among adults experiencing homelessness. Public Health Nursing, 36(3), 321-329. https://doi.org/10.1111/phn.12604.
  • Mohammad, R., Chusid, E., Trepal, M., & Battaglia, F. (2015). Severe chronic heel pain in a diabetic patient with plantar fasciitis successfully treated through transcranial direct current stimulation. Journal of the American Podiatric Medical Association, 105(2), 173-176. https://doi.org/ 10.7547/0003-0538-105.2.173.
  • Nomura, T., Kawae, T., Kataoka, H., & Ikeda, Y. (2018). Assessment of lower extremity muscle mass, muscle strength, and exercise therapy in elderly patients with diabetes mellitus. Environmental Health and Preventive Medicine, 23(1), 1-7. https://doi.org/10.1186/s12199-018-0710-7.
  • Ottum, M. S., & Mistry, A. M. (2015). Advanced glycation end-products: modifiable environmental factors profoundly mediate insulin resistance. Journal of Clinical Biochemistry and Nutrition, 57(1), 1-12. https://doi.org/10.3164/jcbn.15-3.
  • Rosenbaum, A. J., DiPreta, J. A., Misener, D. (2014). Plantar heel pain, Medical Clinics of North America, 98(2), 339-352. https://doi.org/10.1016/j.mcn a.2013.10.009. .
  • Singh, R. B. A. M., Barden, A., Mori, T., & Beilin, L. (2001). Advanced glycation end-products: a review. Diabetologia, 44(2), 129-146. https://doi.org/10.1 007/s001250051591.
  • Tanamas, S. K., Wluka, A. E., Berry, P., Menz, H. B., Strauss, B. J., Davies‐Tuck, M., ... & Cicuttini, F. M. (2012). Relationship between obesity and foot pain and its association with fat mass, fat distribution, and muscle mass. Arthritis Care & Research, 64(2), 262-268. https://doi.org/10. 1002/acr.20663.
  • Taş, S., Bek, N., Ruhi Onur, M., & Korkusuz, F. (2017). Effects of body mass index on mechanical properties of the plantar fascia and heel pad in asymptomatic participants. Foot & Ankle International, 38(7), 779-784. https://doi.org/ 10.1177/1071100717702463.
  • Tsai, Y. J., Yang, Y. C., Lu, F. H., Lee, P. Y., Lee, I. T., & Lin, S. I. (2016). Functional balance and its determinants in older people with diabetes. PloS one, 11(7), e0159339. https://doi.org/10.1371 /journal.pone.0159339.
  • Ursini, F., Arturi, F., Nicolosi, K., Ammendolia, A., D’Angelo, S., Russo, E., ... & Grembiale, R. D. (2017). Plantar fascia enthesopathy is highly prevalent in diabetic patients without peripheral neuropathy and correlates with retinopathy and impaired kidney function. PLoS One, 12(3), e0174529. https://doi.org/10.1371/journal.pon e.0174529.
  • Vaillant, J., Rouland, A., Martigné, P., Braujou, R., Nissen, M. J., Caillat-Miousse, J. L., ... & Juvin, R. (2009). Massage and mobilization of the feet and ankles in elderly adults: effect on clinical balance performance. Manual Therapy, 14(6), 661-664. https://doi.org/10.1016/j.math.2009.03.004

Year 2024, Volume: 13 Issue: 1, 1 - 10, 20.03.2024

Mehmet Duray Nilüfer Çetişli Korkmaz Buse Kılınç Semin Melahat Fenkçi

https://doi.org/10.53424/balikesirsbd.1233393

Abstract

Keywords

Balance Body Mass Index Diabetes Mellitus Function Plantar Pain.

Project Number

1919B011703063

References

  • Awale, A., Hagedorn, T. J., Dufour, A. B., Menz, H. B., Casey, V. A., & Hannan, M. T. (2017). Foot function, foot pain, and falls in older adults: the Framingham foot study. Gerontology, 63(4), 318-324. https://doi.org/10.1159/000475710.
  • Barnes, A., Sullivan, J., Pappas, E., Adams, R., & Burns, J. (2017). Clinical and functional characteristics of people with chronic and recent‐onset plantar heel pain The Journal of Injury, Function and Rehabilitation, 9(11), 1128-1134. https://doi.org/1 0.1016/j.pmrj.2017.04.009.
  • Chatterton, B. D., Muller, S., & Roddy, E. (2015). Epidemiology of posterior heel pain in the general population: Cross‐sectional findings from the clinical assessment study of the foot. Arthritis Care & Research, 67(7), 996-1003. https:// doi.org/10.1002/acr.22546.
  • Cheing, G. L., Chau, R. M., Kwan, R. L., Choi, C. H., & Zheng, Y. P. (2013). Do the biomechanical properties of the ankle–foot complex influence postural control for people with Type 2 diabetes?. Clinical Biomechanics, 28(1), 88-92. https://doi.org/10.1016/j.clinbiomech.2012.09.001.
  • Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., ... & Tate, D. F. (2016). Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079. https://doi.org/10.2337/dc16-1728.
  • Duffin, A. C., Lam, A., Kidd, R., Chan, A. K. F., & Donaghue, K. C. (2002). Ultrasonography of plantar soft tissues thickness in young people with diabetes. Diabetic Medicine, 19(12), 1009-1013. https://doi.org/10.10 46/j.1464-5491.2002.00850.x.
  • Frames, C. W., Soangra, R., Lockhart, T. E., Lach, J., Ha, D. S., Roberto, K. A., & Lieberman, A. (2018). Dynamical properties of postural control in obese community-dwelling older adults. Sensors, 18(6), 1692. https://doi.org/10.3390/s18061692.
  • Garrow, A. P., Papageorgiou, A. C., Silman, A. J., Thomas, E., Jayson, M. I., & Macfarlane, G. J. (2000). Development and validation of a questionnaire to assess disabling foot pain. Pain, 85(1-2), 107-113. https://doi.org/10.1016/S0304-3959(99)00263-8.
  • Giacomozzi, C., D’ambrogi, E., Uccioli, L., & Macellari, V. (2005). Does the thickening of Achilles tendon and plantar fascia contribute to the alteration of diabetic foot loading?. Clinical Biomechanics, 20(5), 532-539. https://doi.org/10.1016/j.clinbiomech.2005.0 1.011.
  • Gomes, A. A., Ackermann, M., Ferreira, J. P., Orselli, M. I. V., & Sacco, I. C. (2017). Muscle force distribution of the lower limbs during walking in diabetic individuals with and without polyneuropathy. Journal Of Neuroengineering And Rehabilitation, 14(1), 1-13. https://doi.org/10.1186/s12984-017-0327-x.
  • Hansen, M. S., Dieckmann, B., Jensen, K., & Jakobsen, B. W. (2000). The reliability of balance tests performed on the kinesthetic ability trainer (KAT 2000). Knee Surgery, Sports Traumatology, Arthroscopy, 8(3), 180-185. https://doi.org/10.1007/s001670050211.
  • Hazari, A., Maiya, A. G., Shivashankara, K. N., Agouris, I., Monteiro, A., Jadhav, R., ... & Mayya, S. S. (2016). Kinetics and kinematics of diabetic foot in type 2 diabetes mellitus with and without peripheral neuropathy: a systematic review and meta-analysis. Springerplus, 5(1), 1-19. https://doi.org/10.1186/s40 064-016-3405-9.
  • Kera, T., Kawai, H., Hirano, H., Kojima, M., Watanabe, Y., Fujiwara, Y., ... & Obuchi, S. (2018). Comparison of body composition and physical and cognitive function between older Japanese adults with no diabetes, prediabetes and diabetes: a cross‐sectional study in community‐dwelling Japanese older people. Geriatrics & Gerontology International, 18(7), 1031-1037. https://doi.org/10.1111/ggi.13301.
  • Külünkoğlu, B., Firat, N., Yildiz, N. T., & Alkan, A. (2018). Reliability and validity of the Turkish version of the Foot Function Index in patients with foot disorders. Turkish Journal of Medical Sciences, 48(3), 476-483. https://doi.org/10.3906/sag-1705-143.
  • Lim, K. B., Kim, D. J., Noh, J. H., Yoo, J., & Moon, J. W. (2014). Comparison of balance ability between patients with type 2 diabetes and with and without peripheral neuropathy. Archives of Physical Medicine and Rehabilitation, 6(3), 209-214. https://doi.org/10.1016/j.pmrj.2013.11.007.
  • Matos, M., Mendes, R., Silva, A. B., & Sousa, N. (2018). Physical activity and exercise on diabetic foot related outcomes: A systematic review. Diabetes Research and Clinical Practice, 139, 81-90. https://doi.org/10.1016/j.diabres.2018.02.020.
  • Menz, H. B., Munteanu, S. E., Zammit, G. V., & Landorf, K. B. (2010). Foot structure and function in older people with radiographic osteoarthritis of the medial midfoot. Osteoarthritis and Cartilage, 18(3), 317-322. https://doi.org/10.1016/j.joca.200 9.11.010.
  • Mickle, K. J., & Steele, J. R. (2015). Obese older adults suffer foot pain and foot-related functional limitation. Gait & Posture, 42(4), 442-447. https://doi.org/10.1016/j.gaitpost.2015.07.013.
  • Moes, J. (2019). Proper fitting shoes: reducing pain, increasing activity, and improving foot health among adults experiencing homelessness. Public Health Nursing, 36(3), 321-329. https://doi.org/10.1111/phn.12604.
  • Mohammad, R., Chusid, E., Trepal, M., & Battaglia, F. (2015). Severe chronic heel pain in a diabetic patient with plantar fasciitis successfully treated through transcranial direct current stimulation. Journal of the American Podiatric Medical Association, 105(2), 173-176. https://doi.org/ 10.7547/0003-0538-105.2.173.
  • Nomura, T., Kawae, T., Kataoka, H., & Ikeda, Y. (2018). Assessment of lower extremity muscle mass, muscle strength, and exercise therapy in elderly patients with diabetes mellitus. Environmental Health and Preventive Medicine, 23(1), 1-7. https://doi.org/10.1186/s12199-018-0710-7.
  • Ottum, M. S., & Mistry, A. M. (2015). Advanced glycation end-products: modifiable environmental factors profoundly mediate insulin resistance. Journal of Clinical Biochemistry and Nutrition, 57(1), 1-12. https://doi.org/10.3164/jcbn.15-3.
  • Rosenbaum, A. J., DiPreta, J. A., Misener, D. (2014). Plantar heel pain, Medical Clinics of North America, 98(2), 339-352. https://doi.org/10.1016/j.mcn a.2013.10.009. .
  • Singh, R. B. A. M., Barden, A., Mori, T., & Beilin, L. (2001). Advanced glycation end-products: a review. Diabetologia, 44(2), 129-146. https://doi.org/10.1 007/s001250051591.
  • Tanamas, S. K., Wluka, A. E., Berry, P., Menz, H. B., Strauss, B. J., Davies‐Tuck, M., ... & Cicuttini, F. M. (2012). Relationship between obesity and foot pain and its association with fat mass, fat distribution, and muscle mass. Arthritis Care & Research, 64(2), 262-268. https://doi.org/10. 1002/acr.20663.
  • Taş, S., Bek, N., Ruhi Onur, M., & Korkusuz, F. (2017). Effects of body mass index on mechanical properties of the plantar fascia and heel pad in asymptomatic participants. Foot & Ankle International, 38(7), 779-784. https://doi.org/ 10.1177/1071100717702463.
  • Tsai, Y. J., Yang, Y. C., Lu, F. H., Lee, P. Y., Lee, I. T., & Lin, S. I. (2016). Functional balance and its determinants in older people with diabetes. PloS one, 11(7), e0159339. https://doi.org/10.1371 /journal.pone.0159339.
  • Ursini, F., Arturi, F., Nicolosi, K., Ammendolia, A., D’Angelo, S., Russo, E., ... & Grembiale, R. D. (2017). Plantar fascia enthesopathy is highly prevalent in diabetic patients without peripheral neuropathy and correlates with retinopathy and impaired kidney function. PLoS One, 12(3), e0174529. https://doi.org/10.1371/journal.pon e.0174529.
  • Vaillant, J., Rouland, A., Martigné, P., Braujou, R., Nissen, M. J., Caillat-Miousse, J. L., ... & Juvin, R. (2009). Massage and mobilization of the feet and ankles in elderly adults: effect on clinical balance performance. Manual Therapy, 14(6), 661-664. https://doi.org/10.1016/j.math.2009.03.004
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Mehmet Duray 0000-0002-3764-215X

Nilüfer Çetişli Korkmaz 0000-0003-3471-8240

Buse Kılınç 0000-0001-9822-0965

Semin Melahat Fenkçi 0000-0002-5658-459X

Project Number 1919B011703063
Publication Date March 20, 2024
Submission Date January 12, 2023
Published in Issue Year 2024 Volume: 13 Issue: 1

Cite

APA Duray, M., Çetişli Korkmaz, N., Kılınç, B., Fenkçi, S. M. (2024). Plantar Pain, Balance and Foot Functions in Individuals with Diabetes Mellitus. Balıkesir Sağlık Bilimleri Dergisi, 13(1), 1-10. https://doi.org/10.53424/balikesirsbd.1233393
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