STUDY OF THE BILATERAL ASYMMETRY OF PLANTAR MECHANICAL PROPERTIES AS A BIOMARKER FOR THE DIFFERENTIATION OF DIABETIC CONDITION

Abstract

Diabetes mellitus is a globally prevalent metabolic disease which results in altered plantar mechanical properties and foot ulcer. In this study, the bilateral asymmetry of mechanical properties for plantar soft tissue is investigated in healthy and diabetic conditions. Myotonometric signals are acquired from sub-metatarsal region of the plantar faces of healthy subjects and patients with varied diabetic age. Mechanical parameters such as dynamic stiffness and logarithmic decrement are extracted from the recorded signal. The asymmetry indices between right and left feet are computed. Statistical analysis shows that the spatial pattern of dynamic stiffness and logarithmic decrement varies significantly between healthy and diabetic subjects. The asymmetry index of dynamic stiffness in the fifth sub-metatarsal head can differentiate between healthy subjects and patients with both high and low diabetic age (p<0.05). The asymmetry index of logarithmic decrement is found to vary significantly between the healthy subjects and patients with higher diabetic age (p<0.05). These results indicate that bilateral asymmetry of myotonometric parameters can be exploited as a possible biomarker to differentiate diabetic patients from healthy subjects and can aid in the early detection of foot ulcer.