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Kinetics and kinematics of diabetic foot in type 2 diabetes mellitus with and without peripheral neuropathy: a systematic review and meta-analysis.

Hazari, Animesh; Maiya, Arun G.; Shivashankara, K.N.; Agouris, Ioannis; Monteiro, Ashma; Jadhav, Radhika; Kumar, Sampath; Kumar, C.G. Shashi; Mayya, Shreemathi S.


Animesh Hazari

Arun G. Maiya

K.N. Shivashankara

Ashma Monteiro

Radhika Jadhav

Sampath Kumar

C.G. Shashi Kumar

Shreemathi S. Mayya


Diabetes mellitus patients are at increased risk of developing diabetic foot with peripheral neuropathy, vascular and musculoskeletal complications. Problems develop with a relatively high risk of infection, gangrene and amputation. In addition, altered plantar pressure distribution is an important etiopathogenic risk factor for the development of foot ulcers. The purpose of this systematic review is to understand the biomechanical changes involved through studies of foot kinematic and kinetic in type 2 diabetes mellitus. Scientific articles were identified using electronic databases including Science Direct, CINAHL, Springer Link, Medline, Web of Science, and Pubmed. The selection of articles to include in the systematic review was narrorwed after reading the full text, focusing on studies that used experimental designs relating to the biomechanics of diabetic foot. The meta-analysis report on gait velocity (neuropathy = 128 and non-diabetes = 131) showed that there was a significantly lower gait velocity in neuropathy participants compared to non-diabetes age-matched participants at a high effect level (-0.09, 95% CI -0.13 to 0.05; p < 0.0001). Regarding knee-joint flexion range, there was a significant difference between neuropathy and non-diabetes groups (4.75, 95% CI, -7.53 to 1.97, p = 0.0008). The systematic review found significant differences in kinematic and kinetic variables among diabetic with neuropathy, diabetic without neuropathy and non-diabetic individuals. The review also found that the sample sizes used in some studies were not statistically significant enough contribute reliably to the meta-analysis, so further studies with higher sample sizes are required.


HAZARI, A., MAIYA, A.G., SHIVASHANKARA, K.N., AGOURIS, I., MONTEIRO, A., JADHAV, R., KUMAR, S., KUMAR, C.G.S. and MAYYA, S.S. 2016. Kinetics and kinematics of diabetic foot in type 2 diabetes mellitus with and without peripheral neuropathy: a systematic review and meta-analysis. SpringerPlus [online], 5, article number 1819. Available from:

Journal Article Type Review
Acceptance Date Sep 28, 2016
Online Publication Date Oct 19, 2016
Publication Date Oct 19, 2016
Deposit Date Feb 14, 2017
Publicly Available Date Feb 14, 2017
Journal SpringerPlus
Electronic ISSN 2193-1801
Publisher Springer
Peer Reviewed Peer Reviewed
Volume 5
Article Number 1819
Keywords Type 2 diabetes; Foot problems; Systematic review; Foot kinematic and kinetic
Public URL


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