The sensory role of the sole of the foot: Review and update on clinical perspectives

Publication date: Available online 29 January 2020Source: Neurophysiologie CliniqueAuthor(s): Frederic J.F. ViseuxSummaryThe feet constitute an important sensory structure in the mechanisms of postural control. As a direct and often only interface between the body and the ground, the feet allow us to sense and interact with our environment. Sensory information provided by muscle and cutaneous afferents in the foot contribute to our ability to stand upright, and postural sway is necessary to detect both position and motion of the body in space. A decline in foot sole skin sensitivity occurs naturally with aging and as a result of neurological disorders, including different peripheral neuropathies, the commonest etiologies of which are diabetes mellitus or effects of chemotherapy. This decline in sensitivity is frequently associated with poorer postural control and increased risk of falls in these populations. The purpose of this comprehensive review is to summarize the evidence that supports a functional role of foot sole sensory tactile and muscular feedback in standing balance, and the postural consequences when this feedback is impaired with aging or disease. This brings new clinical perspectives on the development of intervention strategies to improve the quality of foot sole cutaneous feedback. It also seems to be a promising approach in the management of patients with balance disorders, with specific chronic pain syndromes, with neurologic diseases or those at risk of fa...
Source: Neurophysiologie Clinique - Category: Neuroscience Source Type: research

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Diabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes mellitus. It leads to distressing and expensive clinical sequelae such as foot ulceration, leg amputation, and neuropathic pain (painful-DPN). Unfortunately, DPN is often diagnosed late when irreversible nerve injury has occurred and its first presentation may be with a diabetic foot ulcer. Several novel diagnostic techniques are available which may supplement clinical assessment and aid the early detection of DPN. Moreover, treatments for DPN and painful-DPN are limited. Only tight glucose control in type 1 diabetes has robust evidence in re...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
A 58-year-old man with type 1 diabetes mellitus (hemoglobin A1c level, 6.5% [reference range, 4.0%-5.6%]) complicated by diabetic nephropathy (chronic kidney disease stage 3A), retinopathy, and severe peripheral neuropathy presented to his local urgent care center with a 24-hour history of right dorsal midfoot erythema and mild pain. Two weeks previously, the patient sustained a right foot injury after falling out of bed. The patient had not experienced fevers, chills, night sweats, nausea, vomiting, or malaise but reported somewhat labile blood sugar levels that day with an afternoon glucose measurement of 170 mg/dL (refe...
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Residents ’ clinic Source Type: research
ConclusionsThis is the first study to highlight the characteristic features of Stage 0 ACN in Indian Type 2 Diabetes patients. Thorough clinical evaluation, infrared thermometry and radiological findigs on MRI foot leads to early disease detection. Complete offloading, preferably with total contact casts can prevent disease progression and chronic deformities.
Source: Diabetes and Metabolic Syndrome: Clinical Research and Reviews - Category: Endocrinology Source Type: research
Abstract Peripheral neuropathy, a chronic complication of diabetes mellitus (DM), is often accompanied by the onset of severe pain symptoms that affect quality of life. However, the underlying mechanisms remain elusive. In the present study, we used Sprague-Dawley rats to establish a rodent model of the human type 1 DM by a single intraperitoneal (i.p.) injection with streptozotocin (STZ) (60 mg/kg). Hypersensitivity, including hyperalgesia and allodynia, developed in the STZ-induced diabetic rats. Cutaneous innervation exhibited STZ-induced reductions of protein gene product 9.5-, peripherin-, and neurofil...
Source: Neurotoxicology - Category: Neurology Authors: Tags: Neurotoxicology Source Type: research
ConclusionsUnder the conditions tested, Con ‐DRGS and Burst‐DRGS are equally effective in attenuating STZ‐induced mechanical hypersensitivity in an animal model of PDPN. Burst‐DRGS showed signs of a residual effect at 15 min after cessation of stimulation, which requires further investigation.
Source: Neuromodulation: Technology at the Neural Interface - Category: Biotechnology Authors: Tags: Basic Research Source Type: research
Authors: Papanas N, Maltezos E Abstract In people with diabetes mellitus, the Charcot foot is a specific manifestation of peripheral neuropathy that may involve autonomic neuropathy with high blood flow to the foot, leading to increased bone resorption. It may also involve peripheral somatic polyneuropathy with loss of protective sensation and high risk of unrecognized acute or chronic minor trauma. In both cases, there is excess local inflammatory response to foot injury, resulting in local osteoporosis. In the Charcot foot, the acute and chronic phases have been described. The former is characterized by local ery...
Source: Diabetic Foot and Ankle - Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
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Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: Commentary Source Type: research
Conclusions: Diabetic neuropathies can involve any segment of peripheral nerves from nerve roots to the nerve endings giving different patterns of abnormal sensation. It is the involvement of small fibers that causes positive sensory symptoms like pain early during the course of disease, bringing subjects to physician’s care. Clinical Relevance This article emphasizes on the fact that diabetic neuropathies are not a single entity. They are rather different varieties of conditions with more or less separate pathophysiological mechanisms and anatomical localization. Clinicians should keep this in mind when assessing p...
Source: Prosthetics and Orthotics International - Category: Orthopaedics Authors: Tags: Literature Reviews Source Type: research
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