This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. With over 6% of the population in the United States affected by diabetes mellitus (DM), DM has emerged as a significant health problem. The hallmark of DM is multi-system involvement and the lower limbs are frequently involved in the form of foot ulcers. Inability to heal foot ulcers and maintain healing contributes to the high rate of amputation seen in individuals with DM. The development of foot ulcers has been strongly linked with mechanical stress. Changes in ankle muscle characteristics have been postulated to limit forward progression of the leg on the fixed foot during walking. However, the nature, site and mechanisms underlying changes in ankle muscle characteristics are not well understood. These investigators have developed a protocol to standardize the testing of ankle motion and stiffness and have applied their technique successfully in individuals with DM. The addition of magnetic resonance imaging to this protocol offers an innovative yet intuitive approach to obtain unique and valuable insights into mechanisms underlying changes in muscle and tendon in indivduals with DM. This information is important because it may help elucidate underlying mechanisms, add to the understanding of the DM disease process and its effects, and thus may help develop effective intervention strategies.
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