Author's School

Graduate School of Arts & Sciences

Author's Department/Program

Movement Science


English (en)

Date of Award

Spring 4-28-2014

Degree Type


Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

David R Sinacore


Foot progression angle is a spatial walking parameter defined as the orientation of the longitudinal axis of the foot in the transverse plane. Foot progression angle has been linked to the protracted duration and magnitude of regional plantar stresses and loads in areas of the foot at risk for dermal injury in adults with diabetes mellitus and peripheral neuropathy. Prolonged timing and magnitude of elevated plantar stresses and loads on an insensate foot often results in the development and recurrence of neuropathic plantar ulcers in individuals with diabetes mellitus and peripheral neuropathy. The primary objective of this dissertation research was to explore how specific characteristics (magnitude and inter-limb asymmetry) of foot progression angle change with disease progression, to determine static and dynamic predictors of foot progression angle magnitude, and to examine the effect of a modification of foot progression angle on the regional plantar pressure distribution. A portion of this project was to investigate the impact of limited hip joint rotation on external foot progression angle magnitude in individuals with DMPN. This particularly novel aspect of the project represents a considerable expansion of previous literature on hip joint mobility in persons with DM, which has only explored hip joint mobility limitations in the sagittal plane with respect to a decreased walking speed. Given that treatment for joint limitations are within the scope of physical therapist practice, intervention(s) targeting lower extremity joint limitations could potentially serve as treatment sites to minimize risk for NPU development in DMPN.


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