Mechanical properties of extrinsic foot muscles, Achilles tendon, and plantar fascia in patients with a history of diabetic foot ulcers

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dc.authorid0000-0003-3032-683X
dc.authorid0000-0003-2808-9732
dc.authorid0009-0008-3286-2074
dc.contributor.authorVarol, Fatmagul
dc.contributor.authorIlez, Ali
dc.contributor.authorAslan, Yavuz
dc.date.accessioned2026-01-31T15:08:47Z
dc.date.available2026-01-31T15:08:47Z
dc.date.issued2025
dc.departmentİstanbul Beykent Üniversitesi
dc.description.abstractBackground Diabetic foot ulcers (DFU) are a major complication of diabetes, often leading to impaired mobility and increased risk of recurrence due to persistent biomechanical alterations. Understanding the mechanical properties of foot muscles, tendons, and fascia may provide insight into ulcer development, prevention and rehabilitation strategies. This study aimed to assess the biomechanical properties of the extrinsic foot muscles, Achilles tendon (AT), and plantar fascia (PF) in individuals with a history of DFU using myotonometry. Methods A total of 38 diabetic feet with a history of DFU (Wagner Grade 0-1) and 40 healthy controls (HC) were evaluated. The MyotonPRO device was used to measure muscle tone (Natural Oscillation Frequency, F), stiffness, and elasticity in the tibialis anterior (TA), gastrocnemius medialis (GM), gastrocnemius lateralis (GL), AT, and PF. Measurements were performed in standardized positions, with statistical comparisons made between groups using independent t-tests. Results TA and GM showed significantly increased muscle tone and stiffness in the DFU group compared to HC (p < 0.05), whereas GL did not exhibit significant differences. Similarly, PF and AT stiffness were higher in the DFU group (p < 0.05), suggesting alterations in tissue load distribution. No significant differences in elasticity were observed between groups. Conclusions This study highlights persistent mechanical alterations in the TA, GM, AT, and PF in individuals with a history of DFU, despite ulcer healing. The increased stiffness and tone in these structures may contribute to abnormal foot loading patterns, potentially increasing the risk of ulcer recurrence. The findings emphasize the importance of early biomechanical assessment and targeted rehabilitation strategies, such as neuromuscular training, load redistribution, Achilles tendon stretching and custom orthotic interventions to mitigate mechanical dysfunction in diabetic foot patients.
dc.identifier.doi10.1186/s12891-025-08791-w
dc.identifier.issn1471-2474
dc.identifier.issue1
dc.identifier.pmid40442712
dc.identifier.scopus2-s2.0-105006928577
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org./10.1186/s12891-025-08791-w
dc.identifier.urihttps://hdl.handle.net/20.500.12662/10758
dc.identifier.volume26
dc.identifier.wosWOS:001499020100002
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherBmc
dc.relation.ispartofBmc Musculoskeletal Disorders
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20260128
dc.subjectDiabetic foot ulcer
dc.subjectTone
dc.subjectStiffness
dc.subjectExtrinsic foot muscles
dc.subjectMyotonPRO
dc.titleMechanical properties of extrinsic foot muscles, Achilles tendon, and plantar fascia in patients with a history of diabetic foot ulcers
dc.typeArticle

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