AbstractBackground: One of the common peripheral nerve disorders affecting joint mobility is diabetic Charcot neuroarthropathy which is caused by the chronic disabling painfulcomplication of diabetes termed as Diabetic peripheral neuropathy (DPN).Objective: To evaluate the impact and influence of joint mobility due to DPN and vice versa, by exploring evidence from published studies on joint mobility and its evaluation and management of DPN. Methods: A systematic review using search terms of ‘joint mobility’ and ‘diabetic neuropathy’ was performed in three databases- PubMed, CINAHL and Google scholar to identify relevant citations which were later scrutinized based upon their title, abstract and full-text to include for data extraction and descriptive synthesis into evaluation and interventions for joint mobility in DPN. Results: Of the total list of 26 included studies, there were 21 studies on evaluation of joint mobility in DPN- 10 studies that measured joint mobility (hand function=1, large joints mobility=1, physical examination=1, gait-related joint mobility=7), and 11 studies that related it with other measures/factors (calluses/deformities=1, foot ulceration=7, neurodynamic mechanosensitivity=1, passive ankle stiffness=1, plantar flexor stiffness=1) and there were five studies on interventions and their effects on joint mobility in DPN (Achilles tendon lengthening=1, MABAL shoe=1, total contact cast=1, weight-bearing exercise=1, combined exercises and functional training=1). Conclusion: Limited evidence existed for presence of reduced ankle dorsiflexion and great toe extension in people with DPN, which was demonstrated in gait-related functional kinematic alterations and would predispose the diabetic patient to develop foot ulcers due to alterations in plantar pressures during loading phase of gait. Insufficient evidence existed for special shoe/contact casting for neuropathic ulcer healing, tendo-achilles lengthening surgery and supervised weight-bearing exercise training for improving joint mobility and preventing ulceration in people with DPN.
Keywords: Joint mobility; Mobilization; Diabetic neuropathy; Biomechanics; Kinesiology; Arthrology.