Biomechanical investigation of gait in patients with diabetic foot ulcer

Background: Foot ulceration associated with diabetic peripheral neuropathy is a common concern in Gait abnormalities in this patients can be evaluated and identified by Biomechanical instruments. The purpose of this review paper is to highlight the gait changes in diabetic subjects with foot ulceration.Method: In this systematic review, the databases including google scholar, Pubmed, science direct, Elsevier, otseeker between the years 2009 and 2019 were searched. The selected keywords were gait, diabetic foot ulcer, and biomechanics. Inclusion criteria were access to the full-text articles, lack of interventional study and review of articles were noted. In this process, studies that examined the biomechanical investigation of gait in patients with diabetic foot ulcers were included. After an initial search, more than 34 articles were found. The researchersreviewed the citation review resources after reading the abstracts of the articles to see if they met the inclusion criteria to benefit from all possible articles. Finally, 6 articles that met the inclusion criteria were selected.Findings: There was a large difference between the articles in terms of the measures, evaluated indices, sample size, material and methods.A review of studies showed that patients with diabetic foot ulcer frequently exhibit a conservative gait strategy including slow walking speed, wide base of gait, and prolonged double support time. Glycosylation effects are observed in the lower extremities. Initially, skin thickness decreases and skin hardness increases; tendons thicken; muscles atrophy and exhibit activation delays; bones become less dense; joints have limited mobility; and fat pads are less thick, demonstrate fibrotic atrophy, migrate distally, and maybe stiffer.Conclusion: Abnormalities in gait occur in patients with diabetic foot ulcers and are intimately linked to alterations in kinetics, kinematics, and posture.

Keywords:

gait , diabetic foot ulcer , biomechanics