Associations Between Diabetic Foot Deformity and the Intrinsic Foot Muscles: A Systematic Review
Bibliographic record
Abstract
BACKGROUND: Diabetic foot deformities such as claw toes are debilitating complications. It has been generally accepted that this results from atrophy of the intrinsic foot muscles (IFMs), despite this relationship being underexplored. However, recent diagnostic imaging studies are finding some associations between diabetic intrinsic foot muscles and foot deformity. This new information requires a thorough review of the evidence. OBJECTIVES: Our aim is to systematically review the current literature to investigate any associations between diabetic foot deformity and intrinsic foot muscle changes and review their significance. METHODS: Electronic databases Medline, Embase, Scopus, CINAHL, and Web of Science were searched on 6 May 2020 for all years until 2020. The search was re-run on 26 June 2023 with dates ranging from 2020-2023. Human data studies on adults in English, investigating diabetes, foot deformities and intrinsic foot muscles were included for review. PROSPERO registration was approved on 24 July 2020. RESULTS: Eleven papers out of 1779 met the inclusion criteria. For the updated search, two papers out of the 226 met inclusion criteria. All were assessed for quality using the STROBE criteria and the Newcastle and Ottawa Scale. Six reported various correlations between intrinsic foot muscles and claw/hammer toe deformity measurements. Three papers reported limited or no associations. Three papers investigated medial column deformity (MCD); two found a significant correlation to intrinsic foot muscle atrophy. CONCLUSION: Overall, there is a weak association between diabetic foot deformity and intrinsic foot muscle atrophy and intermuscular adipose tissue infiltration.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".