3.3.1. Range of motion assessment
Studies have shown that the feet of adults with diabetes have
reduced joint mobility than the feet of adults without diabetes
[67–70]. Impaired joint motion or a lack of shock absorption is
considered as a major factor in causing abnormally high plantar
foot pressures that can result in skin breakdown, ulceration and
infection [34,69,71]. So, a range of motion (ROM) assessment is
essential in DM patients. For this propose, the ankle, the subtalar
joint, the metatarsal joints as well as the phalangeal joints should
be moved through their normal ROM to determine whether there
is any pain, restriction to the ROM or crepitus [34].
3.3.2. Muscle strength assessment
Studies have shown a correlation between muscle weakness and
foot ulceration and deformity in DM patients [72–74]. For examina-
tion of muscle strength, the strength of the dorsi flexors, plantar