{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T16:15:59Z","timestamp":1784650559537,"version":"3.55.0"},"reference-count":60,"publisher":"MDPI AG","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>We sought to identify the biomechanical characteristics of the feet of patients with diabetes mellitus and the interrelationship with diabetic neuropathy by determining the range of joint mobility and the presence and locations of calluses and foot deformities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This observational comparative study involved 281 patients with diabetes mellitus who underwent neurologic and vascular examinations. Joint mobility studies were performed, and deformities and hyperkeratosis locations were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>No substantial differences were found between patients with and without neuropathy in joint mobility range. Neuropathy was seen as a risk factor only in the passive range of motion of the first metatarsophalangeal joint (mean \u00b1 SD: 57.2\u00b0 \u00b1 19.5\u00b0 versus 50.3\u00b0 \u00b1 22.5\u00b0, P = .008). Mean \u00b1 SD ankle joint mobility values were similar in both groups (83.0\u00b0 \u00b1 5.2\u00b0 versus 82.8\u00b0 \u00b1 9.3\u00b0, P = .826). Patients without neuropathy had a higher rate of foot deformities such as hallux abductus valgus and hammer toes. There was also a higher presence of calluses in patients without neuropathy (82.8% versus 72.6%; P = .039).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Diabetic neuropathy was not related to limited joint mobility and the presence of calluses. Patients with neuropathy did not show a higher risk of any of the deformities examined. These findings suggest that the etiology of biomechanical alterations in diabetic people is complex and may involve several anatomically and pathologically predisposing factors. (J Am Podiatr Med Assoc 101(3): 208\u2013214, 2011)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7547\/1010208","type":"journal-article","created":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T09:47:28Z","timestamp":1396345648000},"page":"208-214","source":"Crossref","is-referenced-by-count":37,"title":["Foot Biomechanics in Patients with Diabetes Mellitus"],"prefix":"10.3390","volume":"101","author":[{"given":"Jos\u00e9 Luis","family":"L\u00e1zaro-Mart\u00ednez","sequence":"first","affiliation":[{"name":"Diabetic Foot Unit, University Podiatric Clinic, College of Podiatry, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Javier","family":"Arag\u00f3n-S\u00e1nchez","sequence":"first","affiliation":[{"name":"Diabetic Foot Unit, University Podiatric Clinic, College of Podiatry, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Vicente","family":"Beneit-Montesinos","sequence":"first","affiliation":[{"name":"Diabetic Foot Unit, University Podiatric Clinic, College of Podiatry, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximo A.","family":"Gonz\u00e1lez-Jurado","sequence":"first","affiliation":[{"name":"Diabetic Foot Unit, University Podiatric Clinic, College of Podiatry, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther Garc\u00eda","family":"Morales","sequence":"first","affiliation":[{"name":"Diabetic Foot Unit, University Podiatric Clinic, College of Podiatry, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Mart\u00ednez","family":"Hern\u00e1ndez","sequence":"first","affiliation":[{"name":"Diabetic Foot Unit, University Podiatric Clinic, College of Podiatry, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"ref511","doi-asserted-by":"crossref","first-page":"887","DOI":"10.2337\/diacare.23.7.887","article-title":"The 10-g monofilament: the diagnostic divining rod for the diabetic foot.","volume":"23","author":"Armstrong","year":"2000","journal-title":"Diabetes Care"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S1067-2516(02)80081-3","article-title":"Biomechanical abnormalities and ulcers of the great toe in patients with diabetes.","volume":"41","author":"Boffeli","year":"2002","journal-title":"J Foot Ankle Surg"},{"key":"ref441","first-page":"165","article-title":"Association of increased plantar pressures with peripheral sensorimotor and peripheral autonomic neuropathy in Type 2 diabetic patients.","volume":"15","author":"Lobmann","year":"2002","journal-title":"Diabetes Nutr Metab"},{"key":"ref521","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1111\/j.1464-5491.1986.tb00775.x","article-title":"Impaired vibratory perception and diabetic foot ulceration.","volume":"3","author":"Boulton","year":"1986","journal-title":"Diabet Med"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"513","DOI":"10.2337\/diacare.13.5.513","article-title":"Pathways to diabetic limb amputation: basis for prevention.","volume":"13","author":"Pecoraro","year":"1990","journal-title":"Diabetes Care"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"942","DOI":"10.2337\/diacare.27.4.942","article-title":"The role of limited joint mobility in diabetic patients with an at-risk foot.","volume":"27","author":"Zimny","year":"2004","journal-title":"Diabetes Care"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S0891-8422(02)00010-1","article-title":"The effect of ankle equinus upon the diabetic foot.","volume":"19","author":"Van Gils","year":"2002","journal-title":"Clin Podiatr Med Surg"},{"key":"ref431","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.2337\/diacare.27.10.2382","article-title":"Atrophy of foot muscles: a measure of diabetic neuropathy.","volume":"27","author":"Andersen","year":"2004","journal-title":"Diabetes Care"},{"key":"ref91","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S0891-8422(02)00010-1","article-title":"The effect of ankle equinus upon the diabetic foot.","volume":"19","author":"Van Gils","year":"2002","journal-title":"Clin Podiatr Med Surg"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1017\/S0317167100040671","article-title":"Clinical testing in diabetic peripheral neuropathy.","volume":"21","author":"Feldman","year":"1994","journal-title":"Can J Neurol Sci"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"887","DOI":"10.2337\/diacare.23.7.887","article-title":"The 10-g monofilament: the diagnostic divining rod for the diabetic foot.","volume":"23","author":"Armstrong","year":"2000","journal-title":"Diabetes Care"},{"key":"ref271","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.2337\/dc08-2174","article-title":"Role of intrinsic muscle atrophy in the etiology of claw toe deformity in diabetic neuropathy may not be as straightforward as widely believed.","volume":"32","author":"Bus","year":"2009","journal-title":"Diabetes Care"},{"key":"ref371","doi-asserted-by":"crossref","first-page":"942","DOI":"10.2337\/diacare.27.4.942","article-title":"The role of limited joint mobility in diabetic patients with an at-risk foot.","volume":"27","author":"Zimny","year":"2004","journal-title":"Diabetes Care"},{"key":"ref321","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1002\/1520-7560(200009\/10)16:1+<::AID-DMRR139>3.0.CO;2-8","article-title":"What is the most effective way to reduce incidence of amputation in the diabetic 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Surg"},{"key":"ref401","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S1067-2516(02)80081-3","article-title":"Biomechanical abnormalities and ulcers of the great toe in patients with diabetes.","volume":"41","author":"Boffeli","year":"2002","journal-title":"J Foot Ankle Surg"},{"key":"ref541","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.2337\/diacare.26.4.1069","article-title":"Predictive value of foot pressure assessment as part of a population-based diabetes disease management program.","volume":"26","author":"Lavery","year":"2003","journal-title":"Diabetes Care"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1017\/S0317167100040671","article-title":"Clinical testing in diabetic peripheral neuropathy.","volume":"21","author":"Feldman","year":"1994","journal-title":"Can J Neurol Sci"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(03)13169-8","article-title":"Diabetic foot ulcers.","volume":"361","author":"Jeffcoate","year":"2003","journal-title":"Lancet"},{"key":"ref131","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.2337\/diacare.27.10.2382","article-title":"Atrophy of foot muscles: a measure of diabetic neuropathy.","volume":"27","author":"Andersen","year":"2004","journal-title":"Diabetes Care"},{"key":"ref191","doi-asserted-by":"crossref","first-page":"367","DOI":"10.7547\/87507315-93-5-367","article-title":"Do clinical examination variables predict high plantar pressures in the diabetic foot.","volume":"93","author":"Wrobel","year":"2003","journal-title":"JAPMA"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1002\/1520-7560(200009\/10)16:1+<::AID-DMRR139>3.0.CO;2-8","article-title":"What is the most effective way to reduce incidence of amputation in the diabetic foot?","volume":"16","author":"Apelqvist","year":"2000","journal-title":"Diabetes Metab Res 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Biomech"},{"key":"ref451","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1002\/(SICI)1096-9136(199611)13:11<979::AID-DIA267>3.0.CO;2-A","article-title":"The association between callus formation, high pressures and neuropathy in diabetic foot ulceration.","volume":"13","author":"Murray","year":"1996","journal-title":"Diabet Med"},{"key":"ref81","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","year":"1991","journal-title":"Diabetes Care"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1002\/(SICI)1096-9136(199611)13:11<979::AID-DIA267>3.0.CO;2-A","article-title":"The association between callus formation, high pressures and neuropathy in diabetic foot ulceration.","volume":"13","author":"Murray","year":"1996","journal-title":"Diabet 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affects ankle motor function.","volume":"16","author":"Gutierrez","year":"2001","journal-title":"Clin Biomech (Bristol, Avon)"},{"key":"ref561","doi-asserted-by":"crossref","first-page":"216","DOI":"10.2519\/jospt.1995.22.5.216","article-title":"Alignment and joint motion in the normal foot.","volume":"22","author":"Astr\u00f6m","year":"1995","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref381","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","year":"1991","journal-title":"Diabetes Care"},{"key":"ref331","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(03)13169-8","article-title":"Diabetic foot ulcers.","volume":"361","author":"Jeffcoate","year":"2003","journal-title":"Lancet"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/S0021-9290(03)00078-2","article-title":"Forefoot structural predictors of plantar pressures during walking in people with diabetes and peripheral neuropathy.","volume":"36","author":"Mueller","year":"2003","journal-title":"J Biomech"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/S1067-2516(98)80066-5","article-title":"Is there a critical level of plantar foot pressure to identify patients at risk for neuropathic foot ulceration.","volume":"37","author":"Armstrong","year":"1998","journal-title":"J Foot Ankle Surg"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.2337\/diacare.26.4.1069","article-title":"Predictive value of foot pressure assessment as part of a population-based diabetes disease management program.","volume":"26","author":"Lavery","year":"2003","journal-title":"Diabetes Care"},{"key":"ref471","doi-asserted-by":"crossref","first-page":"189","DOI":"10.7547\/0960189","article-title":"Biomechanical risk factors associated with neuropathic ulceration of the hallux in people with diabetes mellitus.","volume":"96","author":"Nube","year":"2006","journal-title":"JAPMA"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1159\/000086373","article-title":"Footwear characteristics and foot problems in older people.","volume":"51","author":"Menz","year":"2005","journal-title":"Gerontology"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.fas.2008.05.004","article-title":"The diabetic foot: an update.","volume":"14","author":"Boulton","year":"2008","journal-title":"Foot Ankle Surg"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/S0268-0033(01)00034-1","article-title":"Mild diabetic neuropathy affects ankle motor function.","volume":"16","author":"Gutierrez","year":"2001","journal-title":"Clin Biomech (Bristol, Avon)"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1111\/j.1464-5491.1986.tb00775.x","article-title":"Impaired vibratory perception and diabetic foot ulceration.","volume":"3","author":"Boulton","year":"1986","journal-title":"Diabet Med"},{"key":"ref591","doi-asserted-by":"crossref","first-page":"S181","DOI":"10.1002\/dmrr.848","article-title":"Practical guidelines on the management and prevention of the diabetic foot: based upon the International Consensus on the Diabetic Foot (2007): prepared by the International Working Group on the Diabetic Foot.","volume":"24","author":"Apelqvist","year":"2008","journal-title":"Diabetes Metab Res Rev"},{"key":"ref141","first-page":"165","article-title":"Association of increased plantar pressures with peripheral sensorimotor and peripheral autonomic neuropathy in Type 2 diabetic patients.","volume":"15","author":"Lobmann","year":"2002","journal-title":"Diabetes Nutr Metab"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1016\/S0140-6736(05)67698-2","article-title":"The global burden of diabetic foot disease.","volume":"366","author":"Boulton","year":"2005","journal-title":"Lancet"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.2337\/diacare.28.6.1425","article-title":"Foot small muscle atrophy is present before the detection of clinical neuropathy.","volume":"28","author":"Greenman","year":"2005","journal-title":"Diabetes Care"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"513","DOI":"10.2337\/diacare.13.5.513","article-title":"Pathways to diabetic limb amputation: basis for prevention.","volume":"13","author":"Pecoraro","year":"1990","journal-title":"Diabetes Care"},{"key":"ref421","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.2337\/diacare.28.6.1425","article-title":"Foot small muscle atrophy is present before the detection of clinical neuropathy.","volume":"28","author":"Greenman","year":"2005","journal-title":"Diabetes Care"},{"key":"ref501","doi-asserted-by":"crossref","first-page":"295","DOI":"10.7547\/87507315-85-6-295","article-title":"Ankle equinus: prevalence and linkage to common foot pathology.","volume":"85","author":"Hill","year":"1995","journal-title":"JAPMA"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1159\/000086373","article-title":"Footwear characteristics and foot problems in older people.","volume":"51","author":"Menz","year":"2005","journal-title":"Gerontology"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.2337\/dc08-2174","article-title":"Role of intrinsic muscle atrophy in the etiology of claw toe deformity in diabetic neuropathy may not be as straightforward as widely believed.","volume":"32","author":"Bus","year":"2009","journal-title":"Diabetes Care"},{"key":"ref171","doi-asserted-by":"crossref","first-page":"189","DOI":"10.7547\/0960189","article-title":"Biomechanical risk factors associated with neuropathic ulceration of the hallux in people with diabetes mellitus.","volume":"96","author":"Nube","year":"2006","journal-title":"JAPMA"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"216","DOI":"10.2519\/jospt.1995.22.5.216","article-title":"Alignment and joint motion in the normal foot.","volume":"22","author":"Astr\u00f6m","year":"1995","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref411","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.2337\/diacare.25.8.1444","article-title":"Intrinsic muscle atrophy and toe deformity in the diabetic neuropathic foot: a magnetic resonance imaging study.","volume":"25","author":"Bus","year":"2002","journal-title":"Diabetes Care"},{"key":"ref01","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1016\/S0140-6736(05)67698-2","article-title":"The global burden of diabetic foot disease.","volume":"366","author":"Boulton","year":"2005","journal-title":"Lancet"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.2337\/diacare.25.8.1444","article-title":"Intrinsic muscle atrophy and toe deformity in the diabetic neuropathic foot: a magnetic resonance imaging study.","volume":"25","author":"Bus","year":"2002","journal-title":"Diabetes Care"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/S0268-0033(99)00085-6","article-title":"Alterations of biochemical and two-dimensional biomechanical properties of human skin in diabetes mellitus as compared to effects of in vitro non-enzymatic glycation.","volume":"15","author":"Reihsner","year":"2000","journal-title":"Clin Biomech (Bristol, Avon)"}],"container-title":["Journal of the American Podiatric Medical 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