Lower limb gait joint coordination variability in people with diabetes-related foot ulcers

Background: Diabetes-related foot ulcers pose substantial health risks globally, yet the biomechanical intricacies underlying their development remain incompletely understood. This study aimed to evaluate lower limb gait joint coordination variability in individuals with diabetes-related foot ulcers compared to those with diabetes (without diabetes-related foot ulcers) and healthy controls.

Methods: A total of 99 participants (diabetes-related foot ulcers cases – 16, Diabetes controls – 50, Health controls – 33) compared three self-paced walking trials. Vector coding, a technique quantifying movement coordination, was employed, analysing hip-knee, knee-ankle, and hip-angle joint couplings in the sagittal plane.

Findings: No significant differences in coordination variability were found among the groups. However, distinct coupling pattern frequencies emerged, with diabetes-related foot ulcers cases exhibiting unique anti-phase hip and ankle coupling frequency counts compared to healthy controls.

Interpretation: These findings challenge conventional understandings of diabetes-related foot ulcers biomechanics and underscore the complexity of gait in this population.