{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T21:08:36Z","timestamp":1793480916382,"version":"4.5.0"},"reference-count":19,"publisher":"MDPI AG","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAPMA"],"published-print":{"date-parts":[[2002,10]]},"abstract":"<jats:p>The authors undertook a study to evaluate the prevalence of ankle equinus and its potential relationship to high plantar pressure in a large, urban population with diabetes mellitus. The first 1,666 consecutive people with diabetes (50.3% male; mean [\u00b1SD] age, 69.1 \u00b1 11.1 years) presenting to a large, urban, managed-care outpatient clinic were enrolled in this longitudinal, 2-year outcomes study. Patients received a standardized medical and musculoskeletal assessment at the time of enrollment, including evaluation at an onsite gait laboratory. Equinus was defined as less than 0\u00b0 of dorsiflexion at the ankle. The overall prevalence of equinus in this population was 10.3%. Patients with equinus had significantly higher peak plantar pressures than those without the deformity and were at nearly three times greater risk for presenting with elevated plantar pressures. There were no significant differences in age, weight, or sex between the two groups. However, patients with equinus had a significantly longer duration of diabetes than those without equinus. Having a high index of suspicion for this deformity and subsequently addressing it through conservative or surgical means may help to reduce the risk of foot ulceration and amputation. (J Am Podiatr Med Assoc 92(9): 479-482, 2002)<\/jats:p>","DOI":"10.7547\/87507315-92-9-479","type":"journal-article","created":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T10:50:04Z","timestamp":1396349404000},"page":"479-482","source":"Crossref","is-referenced-by-count":141,"title":["Ankle Equinus Deformity and Its Relationship to High Plantar Pressure in a Large Population with Diabetes Mellitus"],"prefix":"10.3390","volume":"92","author":[{"given":"Lawrence A.","family":"Lavery","sequence":"first","affiliation":[{"name":"Associate Professor, Department of Orthopaedics, Loyola University, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Director of Research, Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, Tucson; Visiting Senior Lecturer, Department of Medicine, Manchester Royal Infirmary, Manchester, England. Mailing address: Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, 3601 S Sixth Ave, Tucson, AZ 85723."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J. M.","family":"Boulton","sequence":"additional","affiliation":[{"name":"Professor, Department of Medicine, Manchester Royal Infirmary, Manchester, England; Visiting Professor, Department of Medicine, University of Miami, Miami, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"R1","series-title":"J Fam Pract","first-page":"S3","volume":"49","year":"2000","unstructured":"Boulton AJ, Vileikyte L: The diabetic foot: the scope of the problem [review]. .J Fam Pract49::S3. ,2000. .11093553"},{"key":"R2","series-title":"Diabetes Care","first-page":"606","volume":"23","year":"2000","unstructured":"Pham H, Armstrong DG, Harvey C, et al: Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. .Diabetes Care23::606. ,2000. .10834417"},{"key":"R3","series-title":"Arch Intern Med","first-page":"157","volume":"158","year":"1998","unstructured":"Lavery LA, Armstrong DG, Vela SA, et al: Practical criteria for screening patients at high risk for diabetic foot ulceration. .Arch Intern Med158::157. ,1998. .9448554"},{"key":"R4","series-title":"Foot Ankle Int","first-page":"277","volume":"16","year":"1995","unstructured":"Birke JA, Franks BD, Foto JG: First ray joint limitation, pressure, and ulceration of the first metatarsal head in diabetes mellitus. .Foot Ankle Int16::277. ,1995. .7633584"},{"key":"R5","series-title":"Diabetes Care","first-page":"165","volume":"19","year":"1996","unstructured":"Quebedeaux TL, Lavery LA, Lavery DC: The development of foot deformity and ulcers after great toe amputation in diabetes. .Diabetes Care19::165. ,1996. .8718439"},{"key":"R6","series-title":"Arch Intern Med","first-page":"289","volume":"158","year":"1998","unstructured":"Armstrong DG, Lavery LA, Vela SA, et al: Choosing a practical screening instrument to identify patients at risk for diabetic foot ulceration. .Arch Intern Med158::289. ,1998. .9472210"},{"key":"R7","series-title":"J Bone Joint Surg Am","first-page":"535","volume":"81","year":"1999","unstructured":"Armstrong DG, Stacpoole-Shea S, Nguyen H, et al: Lengthening of the Achilles tendon in diabetic patients who are at high risk for ulceration of the foot. .J Bone Joint Surg Am81::535. ,1999. .10225799"},{"key":"R8","series-title":"Foot Ankle Int","first-page":"562","volume":"16","year":"1995","unstructured":"Quaney B, Meyer K, Cornwall MW, et al: A comparison of the dynamic pedobarograph and EMED systems for measuring dynamic foot pressures. .Foot Ankle Int16::562. ,1995. .8563925"},{"key":"R9","series-title":"JAPMA","first-page":"499","volume":"84","year":"1994","unstructured":"Meyers-Rice B, Sugars L, McPoil T, et al: Comparison of three methods for obtaining plantar pressures in nonpathologic subjects. .JAPMA84::499. ,1994. ."},{"key":"R10","series-title":"Clin Podiatr Med Surg","first-page":"11","volume":"15","year":"1998","unstructured":"Armstrong DG, Lavery LA, Harkless LB: Who is at risk for diabetic foot ulceration? [review]. Clin Podiatr Med Surg15::11. ,1998. .9463765"},{"key":"R11","unstructured":"International Working Group on the Diabetic Foot: International Consensus on the Diabetic Foot, International Working Group on the Diabetic Foot, Maastricht, 1999.."},{"key":"R12","series-title":"Diabetes Care","first-page":"1442","volume":"24","year":"2001","unstructured":"Peters EJ, Lavery LA: Effectiveness of the diabetic foot risk classification system of the International Working Group on the Diabetic Foot. .Diabetes Care24::1442. ,2001. .11473084"},{"key":"R13","unstructured":"Kirkwood BR: Essentials of Medical Statistics, Blackwell, Oxford, 1988.."},{"key":"R14","series-title":"J Foot Ankle Surg","first-page":"272","volume":"36","year":"1997","unstructured":"Grant WP, Sullivan R, Sonenshine DE, et al: Electron microscopic investigation of the effects of diabetes mellitus on the Achilles tendon. .J Foot Ankle Surg36::272. ,1997. .9298442"},{"key":"R15","series-title":"J Bone Joint Surg Am","first-page":"365","volume":"80","year":"1998","unstructured":"Armstrong DG, Lavery LA: Elevated peak plantar pressure in patients with Charcot arthropathy. .J Bone Joint Surg Am80::365. ,1998. .9531204"},{"key":"R16","series-title":"J Diabetes Complications","first-page":"208","volume":"11","year":"1997","unstructured":"Arkkila PE, Kantola IM, Viikari JS: Limited joint mobility in non-insulin-dependent diabetic (NIDDM) patients: correlation to control of diabetes, atherosclerotic vascular disease, and other diabetic complications. .J Diabetes Complications11::208. ,1997. .9201597"},{"key":"R17","series-title":"J Pediatr","first-page":"874","volume":"101","year":"1982","unstructured":"Rosenbloom AL, Silverstein JH, Lezotte DC, et al: Limited joint mobility in diabetes mellitus of childhood: natural history and relationship to growth impairment. .J Pediatr101::874. ,1982. .7131180"},{"key":"R18","series-title":"Pediatr Clin North Am","first-page":"569","volume":"31","year":"1984","unstructured":"Rosenbloom AL: Skeletal and joint manifestations of childhood diabetes. .Pediatr Clin North Am31::569. ,1984. .6374589"},{"key":"R19","series-title":"Eur J Pediatr","first-page":"380","volume":"149","year":"1990","unstructured":"Rosenbloom AL: Limited joint mobility in insulin dependent childhood diabetes. .Eur J Pediatr149::380. ,1990. .2185025"}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/92\/9\/87507315-92-9-479.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/japma\/article-pdf\/92\/9\/479\/1413747\/87507315-92-9-479.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/92\/9\/87507315-92-9-479.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/92\/9\/87507315-92-9-479.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:45:24Z","timestamp":1783428324000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/92\/9\/479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,10]]},"references-count":19,"journal-issue":{"issue":"9"},"URL":"https:\/\/doi.org\/10.7547\/87507315-92-9-479","relation":{},"ISSN":["8750-7315","1930-8264"],"issn-type":[{"value":"8750-7315","type":"print"},{"value":"1930-8264","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,10]]}}}