Contribution of XXXX to the increased forefoot pressures in @entity6 @entity1 .

@entity1 @entity101 @entity6 @entity16 @entity1897 @entity1411 @entity121
OBJECTIVES: Secondary to @entity1897 , @entity1411 is a proven risk factor for foot ulceration. But limited joint mobility (LJM) and soft tissue abnormalities may also contribute. The aim of this study was to evaluate the relationships among @entity121 , mobility of the metatarso-phalangeal joint, and forces expressed under the metatarsal heads. RESEARCH DESIGN AND METHODS: We evaluated 61 @entity6 @entity1 : 27 without @entity16 (D group), 19 with @entity16 (DN group), and 15 with previous @entity1411 (DNPU group). We also examined 21 control subjects (C). Ultrasound evaluation was performed with a high resolution 8- to 10-MHz linear array (Toshiba Tosbee SSA 240). The foot loading pattern was evaluated with a piezo-dynamometric platform. First metatarso-phalangeal joint mobility was assessed with a mechanic goniometer. RESULTS: @entity6 @entity1 presented @entity101 (D 2.9 +/- 1.2 mm, DN 3.0 +/- 0.8 mm, DNPU 3.1 +/- 1.0 mm, and C 2.0 +/- 0.5.mm; P < 0.05), and significantly reduced motion range at the metatarso-phalangeal joint (D 54.0 +/- 29.4 degrees, DN 54.9 +/- 17.2 degrees, DNPU 46.8 +/- 20.7 degrees, and C 100.0 +/- 10.0 degrees; P < 0.05). The evaluation of foot-floor interaction under the metatarsal heads showed increased vertical forces in DN and DNPU and increased medio-lateral forces in DNPU. An inverse correlation was found between the @entity121 and metatarso-phalangeal joint mobility (r = -0.53). The @entity121 was directly correlated with vertical forces under the metatarsal heads (r = 0.52). CONCLUSIONS: In @entity6 @entity1 , soft tissue involvement may contribute to the increase of vertical forces under the metatarsal heads. Changes in the structure of @entity1411 may also influence the mobility of the first metatarso-phalangeal joint.
