{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:31:27Z","timestamp":1761989487816,"version":"3.37.3"},"reference-count":23,"publisher":"FapUNIFESP (SciELO)","issue":"2","license":[{"start":{"date-parts":[[2020,2,1]],"date-time":"2020-02-01T00:00:00Z","timestamp":1580515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,2,1]],"date-time":"2020-02-01T00:00:00Z","timestamp":1580515200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,2,1]],"date-time":"2020-02-01T00:00:00Z","timestamp":1580515200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY In diabetics, foot deformities are risk factors that increase the risk of amputation as a result of developing ulcers. However, knowledge of the influence of plantar stiffness is still limited. The main objective was to describe connections between the degree of stiffness of the ankle, atypical amputation, and the Foot Posture Index (FPI).  METHODS  62 diabetic patients, 58 with type 2 and 4 with type 1 (average age 63.35 years) were included. Records of foot deformities were included; A range of motion test of the ankle joint was used to determine the degree of stiffness. An exploratory analysis of the association of foot position and the degree of rigidity was performed.  RESULTS  The dorsal flexion range of the ankle was 9.6 \u00b1 5.1 0, 13.8 \u00b1 5.9 0 and 17.2 \u00b1 6.5 0 and 20.5 \u00b1 6.8 0 to 45, 67, 89 and 111 N respectively in the amputated feet., And 14 patients (22.58%) had a high level of pronation of IPF with an average value of 3.7 \u00b1 2.629, CI (3.032.-4.367) in amputated feet compared to non-amputees. We use the device \u201cIowa ankle range of motion\u201d (IAROM) to determine the differences in ankle stiffness. Proper IPF was associated with the presence of amputation and an increase in stiffness  CONCLUSIONS  There was an increase in the degree of limitation of movement of the ankle, as a greater force was applied. Comparing FPI between the groups, there was a higher frequency of prone feet in the group of amputees<\/jats:p>","DOI":"10.1590\/1806-9282.66.2.216","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T23:14:51Z","timestamp":1589930091000},"page":"216-221","source":"Crossref","is-referenced-by-count":16,"title":["Stiffness degree of ankle range of motion in diabetic patients with atypical amputation"],"prefix":"10.1590","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9653-890X","authenticated-orcid":false,"given":"Eduardo","family":"Sim\u00f3n-P\u00e9rez","sequence":"first","affiliation":[{"name":"Hospital C\/ Felipe II,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3858-0325","authenticated-orcid":false,"given":"Clarisa","family":"Sim\u00f3n-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Hospital Valladolid,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6491-8222","authenticated-orcid":false,"given":"David","family":"Alonso-Pe\u00f1a","sequence":"additional","affiliation":[{"name":"University Hospital \u201cR\u00edo Hortega\u201d,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8627-9932","authenticated-orcid":false,"given":"Alejandro","family":"Pont\u00f3n-Cortina","sequence":"additional","affiliation":[{"name":"Marqu\u00e9s de Valdecilla Hospital,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4766-5723","authenticated-orcid":false,"given":"Esther","family":"Chicharro-Luna","sequence":"additional","affiliation":[{"name":"University Miguel Hern\u00e1ndez,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5536-2509","authenticated-orcid":false,"given":"Alfonso","family":"Mart\u00ednez-Nova","sequence":"additional","affiliation":[{"name":"University of Extremadura,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6170-4779","authenticated-orcid":false,"given":"Emmanuel","family":"Navarro-Flores","sequence":"additional","affiliation":[{"name":"University of Valencia,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2020,2]]},"reference":[{"year":"2016","series-title":"Informe mundial sobre la diabetes","key":"ref1"},{"issue":"3","key":"ref2","first-page":"297","article-title":"Identificaci\u00f3n de las deformidades pod\u00e1licas en personas con diabetes mellitus, una estrategia para prevenir amputaciones","volume":"24","author":"Est\u00e9vez Perera A","year":"2013","journal-title":"Rev Cubana Endocrinol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.diabres.2016.01.008","article-title":"Forefoot ulcer risk is associated with foot type in patients with diabetes and neuropathy","volume":"114","author":"Molines-Barroso RJ","year":"2016","journal-title":"Diabetes Res Clin Pract"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"S583","DOI":"10.1016\/j.dsx.2017.04.008","article-title":"Diabetic foot ulcer carries high amputation and mortality rates, particularly in the presence of advanced age, peripheral artery disease and anemia","volume":"11","author":"Costa RHR","year":"2017","journal-title":"Diabetes Metab Syndr"},{"issue":"4","key":"ref5","first-page":"472","article-title":"Lower extremity amputation rates in diabetic patients","volume":"54","author":"Cisneros-Gonz\u00e1lez N","year":"2016","journal-title":"Rev Med Inst Mex Seguro Soc"},{"issue":"1","key":"ref6","first-page":"95","article-title":"American Diabetes Association Standards of Medical Care in Diabetes 2017","volume":"40","author":"Cefalu WT","year":"2017","journal-title":"J Clin Appl Res Educ"},{"issue":"1","key":"ref7","doi-asserted-by":"crossref","first-page":"7","DOI":"10.2174\/157339913804143216","article-title":"The management of the infected diabetic foot","volume":"9","author":"Caravaggi C","year":"2013","journal-title":"Curr Diabetes Rev"},{"issue":"1","key":"ref8","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/S0895-7967(03)70007-6","article-title":"Maximizing length and optimizing biomechanics in foot amputations by avoiding cookbook recipes for amputation","volume":"16","author":"Attinger C","year":"2003","journal-title":"Semin Vasc Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.clinbiomech.2017.01.021","article-title":"Association between ankle equinus and plantar pressures in people with diabetes. A systematic review and meta-analysis","volume":"43","author":"Searle A","year":"2017","journal-title":"Clin Biomech"},{"key":"ref10","article-title":"Foot deformities, function in the lower extremities, and plantar pressure in patients with diabetes at high risk to develop foot ulcers","volume":"6","author":"Tang UH","year":"2015","journal-title":"Diabet Foot Ankle"},{"issue":"3","key":"ref11","doi-asserted-by":"crossref","first-page":"189","DOI":"10.7547\/14-095","article-title":"Range of motion and plantar pressure evaluation for the effects of self-care foot exercises on diabetic patients with and without neuropathy","volume":"106","author":"Cerrahoglu L","year":"2016","journal-title":"J Am Podiatr Med Assoc"},{"issue":"4","key":"ref12","doi-asserted-by":"crossref","first-page":"274","DOI":"10.2519\/jospt.2011.3397","article-title":"A new device for assessing ankle dorsiflexion motion: reliability and validity","volume":"41","author":"Wilken J","year":"2011","journal-title":"J Orthop Sport Phys Ther"},{"issue":"8","key":"ref13","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1177\/107110070602700809","article-title":"Increased passive ankle stiffness and reduced dorsiflexion range of motion in individuals with diabetes mellitus","volume":"27","author":"Rao SR","year":"2006","journal-title":"Foot Ankle Int"},{"issue":"1","key":"ref14","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.clinbiomech.2005.08.002","article-title":"Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index","volume":"21","author":"Redmond AC","year":"2006","journal-title":"Clin Biomech"},{"issue":"4","key":"ref15","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1056\/NEJM198107233050403","article-title":"Limited joint mobility in childhood diabetes mellitus indicates increased risk for microvascular disease","volume":"305","author":"Rosenbloom AL","year":"1981","journal-title":"N Engl J Med"},{"issue":"1","key":"ref16","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1054\/foot.2000.0581","article-title":"Radiographic measurements and plantar pressure distribution in normal, hallux valgus and hallux limitus feet","volume":"10","author":"Bryant A","year":"2000","journal-title":"Foot"},{"issue":"5","key":"ref17","doi-asserted-by":"crossref","first-page":"172","DOI":"10.2519\/jospt.1988.10.5.172","article-title":"Relationship between hallux limitus and ulceration of the great toe","volume":"10","author":"Birke JA","year":"1988","journal-title":"J Orthop Sports Phys Ther"},{"issue":"3","key":"ref18","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.gaitpost.2005.10.004","article-title":"Ankle ROM and stiffness measured at rest and during gait in individuals with and without diabetic sensory neuropathy","volume":"24","author":"Rao S","year":"2006","journal-title":"Gait Posture"},{"issue":"2","key":"ref19","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.gaitpost.2009.10.016","article-title":"Relationships between segmental foot mobility and plantar loading in individuals with and without diabetes and neuropathy","volume":"31","author":"Rao S","year":"2010","journal-title":"Gait Posture"},{"issue":"1","key":"ref20","doi-asserted-by":"crossref","first-page":"8","DOI":"10.2337\/diacare.14.1.8","article-title":"Relationship of limited joint mobility to abnormal foot pressures and diabetic foot ulceration","volume":"14","author":"Fernando DJ","year":"1991","journal-title":"Diabetes Care"},{"issue":"2","key":"ref21","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.jbiomech.2004.11.024","article-title":"Biomechanical characterization and clinical implications of artificially induced toe-walking: differences between pure soleus, pure gastrocnemius and combination of soleus and gastrocnemius contractures","volume":"39","author":"Matja\u010di\u0107 Z","year":"2006","journal-title":"J Biomech"},{"issue":"3","key":"ref22","doi-asserted-by":"crossref","first-page":"804","DOI":"10.2466\/25.10.PMS.120v16x3","article-title":"Evaluation of bilateral asymmetry between upper limb masses in right-handed young adults of both sexes","volume":"120","author":"Gutnik B","year":"2015","journal-title":"Percept Mot Skills"},{"issue":"7","key":"ref23","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1111\/j.1464-5491.1995.tb00546.x","article-title":"Differences in joint mobility and foot pressures between black and white diabetic patients","volume":"12","author":"Veves A","year":"1995","journal-title":"Diabet Med"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/ramb\/v66n2\/1806-9282-ramb-66-2-0216.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T18:56:38Z","timestamp":1611428198000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302020000200216&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2]]}},"alternative-id":["S0104-42302020000200216"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.66.2.216","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"type":"electronic","value":"1806-9282"},{"type":"print","value":"0104-4230"}],"subject":[],"published":{"date-parts":[[2020,2]]}}}