RELATIONSHIPS BETWEEN MEASURES OF FUNCTION, STRENGTH AND WALKING SPEED IN PATIENTS WITH DIABETES AND TRANSMETATARSAL AMPUTATION

Objective: To determine the correlation! between strength and function al measures, and the intercorrelation between the functional measures themselves, in a group of subjects with diabetes mellitus (DM) and tra nsmetatarsal amputation (TMA). Design: Correlational study. Setting. T he subjects were tested in the Applied Kinesiology Laboratory of the P rogram in Physical Therapy at Washington University School of Medicine , St Louis, MO, USA. Subjects: Thirty subjects with DM and TMA (mean a ge 61.7+/-11.3 years) were studied. Main outcome measures: Function wa s measured using the Functional Reach Test (FR), the Physical Performa nce Test (PPT), the Sickness impact Profile (SIP), and walking speed ( WS) for 15.24 m. Strength measurements were taken using a hand-held dy namometer. Results: Highest correlations were found between hip extens ion strength and PPT: r=0.69, FR: r=0.45, and WS: r=0.76, between knee extension strength and PPT. r=0.48, and WS: r=0.51, between hip flexi on strength and PPT: r=0.51, FR: r=0.47, and WS: r=0.59, between knee flexion strength and PPT: r=0.57, and WS: r=0.63, and between dorsifle xion strength and PPT: r=0.49, and WS: r=0.63. The following intercorr elations between functional measures were significant; PPT and FR: r= 0.66, PPT and SIP: r=-0.54, PPT and WS: r=0.77, FR and WS: r=0.54, SIP and MS: r=-0.47. Conclusions: The relationship between measures of hi p and knee muscle strength and function provides some evidence that re habilitation should focus on strengthening hip and knee extensors and flexors to improve function. The relationships between walking speed a nd strength, PPT, FR and SIP suggest that the simple measure of walkin g speed is a useful functional test in the clinic.