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Plantar pressure distribution and altered postural control in multibacillary leprosy patients.
Da Cruz Junior, Alex Tadeu Viana; Vasconcelos, Beatriz Helena Baldez; Barroso, Tatiana Generoso Campos Pinho; Souza, Givago Silva; Monteiro, Luis Carlos Pereira; Xavier, Marília Brasil; Callegari, Bianca.
Afiliação
  • Da Cruz Junior ATV; Laboratory of Human Motricity Studies, Health Science Institute, Federal University of Para, Belém, Brazil.
  • Vasconcelos BHB; Nucleous of Tropical Medicine, Federal University of Para, Belém, Brazil.
  • Barroso TGCP; Federal University of Roraima, Boa Vista, Brazil.
  • Souza GS; Laboratory of Human Motricity Studies, Health Science Institute, Federal University of Para, Belém, Brazil.
  • Monteiro LCP; Nucleous of Tropical Medicine, Federal University of Para, Belém, Brazil.
  • Xavier MB; Biological Science Institute, Federal University of Para, Belém, Brazil.
  • Callegari B; Biological Science Institute, Federal University of Para, Belém, Brazil.
BMC Infect Dis ; 24(1): 130, 2024 Jan 24.
Article em En | MEDLINE | ID: mdl-38267905
ABSTRACT

BACKGROUND:

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, predominantly affecting the peripheral nerves, resulting in sensory and motor deficits in the feet. Foot ulcers and imbalances are frequent manifestations in leprosy, often correlating with diminished sensitivity. While clinical scales and monofilament esthesiometers are conventionally utilized to evaluate foot sensitivity and balance in these patients, their discriminatory power is limited and their effectiveness is greatly dependent on the examiner's proficiency. In contrast, baropodometry and posturography offer a more comprehensive evaluation, aiming to preempt potential damage events. This study aimed was to assess the correlation between baropodometry and force plate measurements in leprosy patients and control participants, to improve the prevention and treatment of foot ulcers and complications associated with leprosy.

METHODOLOGY:

This cross-sectional study was conducted during 2022 and enrolled 39 participants (22 patients with multibacillary leprosy and 17 non-leprosy controls). Demographic data were collected, and a monofilament esthesiometer was used to assess sensory deficits. In addition, physical examinations and balance and plantar pressure tests were conducted. The Student's t-test was used to compare mean and maximum plantar pressures between groups. For most COP variables, a Mann-Whitney Wilcoxon test was used, except for AP amplitude which was analyzed with the Student's t-test due to its normal distribution. The relationship between foot pressure and balance control was assessed using Spearman's correlation, focusing on areas with significant pressure differences between groups. PRINCIPAL

FINDINGS:

Leprosy patients showed increased pressure in forefoot areas (T1, M1, T2-T5, and M2) and decreased pressure in hindfoot regions (MH and LH) compared to controls. These patients also displayed higher AP and ML amplitudes, suggesting poorer COP control. Correlation analyses between the two groups revealed that foot plantar pressures significantly impact balance control. Specifically, increased T1 region pressures correlated with greater sway in balance tasks, while decreased MH region pressures were linked to reduced COP control. CONCLUSIONS/

SIGNIFICANCE:

The findings suggest a joint disturbance of plantar pressure distribution and static balance control in leprosy patients. These alterations may increase the risk of tissue injuries, including calluses and deformities, as well as falls.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pé Diabético / Hanseníase Multibacilar Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: BMC Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pé Diabético / Hanseníase Multibacilar Tipo de estudo: Observational_studies / Prevalence_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: BMC Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido