Table 3.

Lower limb diabetes-related diseases

Reduced ankle Rom

Clinical features

Plantar fascia and Achilles tendon

Increased thickness in subjects suffering from type I and type II diabetes mellitus.41,42

More frequent in diabetic patients with neuropathy and previous foot ulcers.43–45

Thickness may be also increased in type II diabetic patients free from complications.

Thickness correlates positively with BMI.46

Involvement of Achilles tendon and plantar fascia is associated to reduced ankle joint ROM.

Limited ankle ROM may restrain the forward progression of the tibia on the fixed foot during the stance phase of walking. This, in turn, results in prolonged and excessive weight bearing stress under the metatarsal heads during the foot-floor interaction, which is thought to contribute to the development of foot ulcers in individuals with diabetes mellitus.44,47

Abbreviations: ROM, range of movement; BMI, body mass index.