Cinematic analysis of ankle in sagittal plane of diabetic patient with transtibial amputation. Report of a clinical case
Introduction: Diabetes Mellitus is a chronic metabolic disease, which is rapidly increasing due to changes related to lifestyle and has a major socio-health impact. Ulcers and amputation of the lower limbs are the main cause of morbility, disability, and costs for diabetic patients. Therefore, biomechanical exploration of the foot is essential for the early identification of risk factors for ulceration. Case description: patient with transtibial amputation due to diabetic vascular disease, was performed a 3D walking analysis together with an exhaustive exploration when the physiotherapy treatment finished. He showed hyperkeratosis in the first and fifth metatarsal, in plantar area, as well as alterations in the surface and depth sensitivity. Results: the analysis of the spatio-temporal parameters showed an uneven distribution of the times in monopodal support, being greater in non prosthetic leg. The pitch velocity and the step rate were decreased. The values of maximum dorsal and plantar flexion of the intact lower limb ankle reflect a slight difference in degrees from the normal values. Discussion: the studies for the 3D movement analysis together with the biomechanical exploration of the foot are a useful tool in order to create preventive and treatment strategies, and might have relevant clinical impact.
Keywords: diabetes mellitus, ulcer, amputation, ankle joint, gait.