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This article is part of the supplement: 3rd Congress of the International Foot and Ankle Biomechanics Community

Open Access Open Badges Oral presentation

Foot type biomechanics in diabetic and not diabetic subjects

Zimi Sawacha1*, Annamaria Guiotto1, Gabriella Guarneri2, Angelo aogaro2 and Claudio Cobelli1

Author Affiliations

1 Department of Information Engineering, University of Padova, Padova, 35100, Italy

2 Department of Clinical Medicine and Metabolic Disease, University Polyclinic, Padova, 35136, Italy

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Journal of Foot and Ankle Research 2012, 5(Suppl 1):O13  doi:10.1186/1757-1146-5-S1-O13

The electronic version of this article is the complete one and can be found online at:

Published:10 April 2012

© 2012 Sawacha et al; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The aim of this study was to investigate the role of foot morphology with respect to diabetes and peripheral neuropathy in altering foot kinematics, kinetics and plantar pressure (PP) during gait.

Materials and methods

Simultaneous 3-dimensional multisegment foot kinematics [1], kinetics and PP [2] of healthy and diabetic subjects with different type of foot were determined. 120 feet were examined (cavus, valgus heel and hallux valgus): 40 feet in the control group (CG), 80 feet respectively in the diabetic ((D) and in the neuropathic (N) groups. Furthermore, subjects were classified according to their foot morphology and each of the 3 groups was splitted in subgroups: 1. cavus foot, 2. cavus foot and valgus heel, 3. cavus foot and hallux valgus, 4. normal foot, 5. cavus foot and normally aligned heel, 6. cavus foot and normal hallux).


D and N subjects of groups 1, 2 and 5 differed significantly (p<0.05) from CG matched for foot morphology. Most of all D subjects in groups 1 and 2 were significantly more likely to display lower triplanar foot subsegments range of motion (especially in midfoot-forefoot dorsi-plantarflexion angle) and higher peak PP mainly in correspondence of the forefoot.

thumbnailFigure 1. Results for midfoot-hindfoot inversion-eversion angle in each group from 1 to 6 for CG (yellow), D (red), N (blue).


Results indicated the important role of foot morphology in altering the biomechanics of diabetic subjects.


  1. Cavanagh PR, Simoneau GG, Ulbrecht JS: Ulceration, unsteadiness, and uncertainty, the biomechanical consequences of diabetes mellitus.

    J Biomech 2003, 26:23-40. OpenURL

  2. Sawacha Z, et al.: Characterizing multisegment foot kinematics during gait in diabetic foot patients.

    J Neuroeng Rehab 2009, 6:37. BioMed Central Full Text OpenURL

  3. Giacomozzi C, et al.: The role of shear stress in the etiology of diabetic neuropathic foot ulcers.

    J Foot Ankle Res 2008, 1:S1. OpenURL