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J. Myoung-Hyun1, S. Janghoon1, L. Wan-Hee1
1Department of Physical Therapy, Sahmyook University College of Health Science, Physical Therapy, Seoul, Republic of Korea, Korea (Republic of)
Background: At least 20% of the elderly over the age of 65 have diabetes. And it is expected to increase rapidly in the future. In diabetic patients, the limited range of motion of the ankle joint leads to an abnormal increase in plantar pressure, which damages the feet of diabetic patients who already have soft tissue changes. Therefore, increasing the range of motion of the ankle joint can be a solution to reducing plantar pressure in diabetics.
Purpose: This study was conducted to investigate the effect of joint mobilization on ankle joint range of motion, Plantar pressure and balance for elderly diabetic patients.
Methods: 27 participants who were selected for the conditions of the study were randomly allocated to two group: group with ankle joint mobilization (AJM group)(n=14) and control group(n=13). Two groups were given bicycle , which was conducted 30 minutes, 3 times per week for 5 weeks. AJM group subjects received ankle joint mobilization, which was conducted 20 minutes, 3 time per week for 5 weeks. We measured joint angle using a Goniometer meters in joint range of motion assessment to determine the effectiveness of the interventions, Functional reach test to assess the dynamic balance, to evaluate the Foot Pressure RS-foot scan using the Peak plantar pressure, Stance contact time percent, Total stance time, COP X-excursion, was measured COP Y-excursion.
Results: The experimental joint range of motion and Functional reach test showed a significantly improved result from (p < 0.05), Peak plantar pressure in the Heel and Forefoot is significantly reduced in the AJM group showed (p < 0.05), Heel and Hallux contact time percent were significantly different in AJM group(p < 0.05), the Total stance time in the AJM group showed a significant decrease (p < 0.05), COP Y-excursion were significantly increased in the experimental group (p < 0.05).
Conclusion(s): In this study, joint mobilization improved the range of motion, decreased peak plantar pressure in the forefoot and heel, increased the ratio of the big toe contact time, decreased the stance contact time ratio of the heel, increased the length of the longitudinal axis of the pressure and the overall stance phase. It proved to be effective in walking strategies of the ankle joint such as reduction of time, and it is considered to be a significant treatment method for balance. In the future, it is expected that the physical disability of elderly diabetic patients will be accurately understood, and joint mobilization will be spread as a program on ankle disability, which will have a more positive effect on treatment and prevention activities.
Implications: Joint Mobilization Through this study effects on the ankle joint range of motion and promotes balance of elderly diabetic patients, and decreases foot plantar pressure and effects on the strategy of the ankle joint during walking. Based on these results, increase of ankle joint range of motion through the joint mobilization, as a effective way for balance and foot plantar pressure, is expected to be able to take advantage of physical therapy in the clinical approach.
Funding, acknowledgements: This work was supported by the National Research Foundation (NRF) grant funded by Korea government (No. NRF-2018R1D1A1B0704287013)
Keywords: diabetes, ankle joint, plantar
Topic: Musculoskeletal: lower limb
Did this work require ethics approval? Yes
Institution: Institution Review Board of Sahmyook University, Seoul
Committee: Bioethics Committee
Ethics number: 2-7001793-AB-N-012019072HR
All authors, affiliations and abstracts have been published as submitted.
