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Title: Do the biomechanical properties of the ankle-foot complex influence postural control for people with Type 2 diabetes?
Authors: Cheing, GLY 
Chau, RMW
Kwan, RLC
Choi, CH
Zheng, YP 
Keywords: Balance
Diabetic neuropathy
Plantar soft tissue
Issue Date: 2013
Publisher: Pergamon Press
Source: Clinical biomechanics, 2013, v. 28, no. 1, p. 88-92 How to cite?
Journal: Clinical biomechanics 
Abstract: Background: The ankle-foot complex plays an important role in the mechanics of postural control. The objectives of this study were to compare the biomechanical properties of the ankle-foot complex of people with diabetes who had or did not have peripheral neuropathy with those healthy individuals; and to examine its correlation with postural control. Methods: A total of 64 individuals participated in this study: 9 people with diabetic peripheral neuropathy, 23 diabetes without neuropathy, and 32 healthy controls. A hand-held ultrasound indentation system was used to assess the soft tissue biomechanical properties of the ankle-foot complex. The Sensory Organization test was performed using The Smart EquiTest system to assess postural control. Findings: The soft tissue of the Achilles tendon was significantly thickened in all individuals with diabetes (P < 0.001), and was associated with the vestibular ratio (r = 0.40; P < 0.05). The Young's modulus of the plantar soft tissue was significantly increased in the diabetic neuropathy group (all P < 0.05). Also, the Young's modulus of the plantar soft tissue at the first metatarsal head was positively correlated with the somatosensory ratio (r = 0.46; P < 0.05) and visual ratio (r = 0.39; P < 0.05). Interpretation: Diabetic patients with or without neuropathy had a thicker Achilles tendon and stiffer plantar soft tissue than the healthy control. Changes in the biomechanical properties of the ankle-foot complex were correlated with the use of vestibular, somatosensory or visual inputs to maintain balance in individuals with diabetes.
ISSN: 0268-0033
EISSN: 1879-1271
DOI: 10.1016/j.clinbiomech.2012.09.001
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