Midfoot and ankle motion during heel rise and gait are related in people with diabetes and peripheral neuropathy.
Hyo-Jung Jeong, Michael J Mueller, Jennifer A Zellers and 1 others
PMID 33264731WHAT IT FOUND
In people with diabetes and peripheral neuropathy, midfoot and ankle position at peak single-limb heel rise tracked position at peak ankle power during walking.
People who dorsiflexed at heel rise also showed more dorsiflexion during stance.
Key findings
01Midfoot and ankle angles at peak double-limb heel rise were significantly correlated with midfoot and ankle angles at peak ankle power during walking.
02Midfoot and ankle angles at peak single-limb heel rise were significantly correlated with midfoot and ankle angles at peak ankle power during walking.
03People whose midfoot and ankle were dorsiflexed at peak single-limb heel rise had less plantarflexion during heel rise and greater dorsiflexion at peak ankle power during gait than those whose midfoot and ankle plantarflexed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was a secondary analysis of baseline data and was cross-sectional, so it cannot show that heel rise movement causes gait movement problems or that changing heel rise will change walking. The sample size was powered for the parent intervention study, not for this correlation analysis, and no a priori power analysis was done for this secondary analysis. Gait was measured only at self-selected speed, so the findings may not apply to faster or slower walking. The findings are specific to people with diabetes and peripheral neuropathy and may not apply to other foot and ankle conditions. Six participants with diabetes and peripheral neuropathy walked with hand support for safety, which may have affected gait mechanics. The subgroup analysis was secondary, so it should not be treated as the main tested question.
Declared interests
The supplied publication types list research support from NIH extramural and non-U.S. government sources. The provided text does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not conclude that heel rise training or plantarflexor strengthening will improve gait or prevent ulcers. This study measured an association between movement patterns, not a treatment effect.