History, prevalence and assessment of limited joint mobility: from stiff hand syndrome to diabetic foot ulcer prevention

Diabetes mellitus (DM) is one of the most important global public health problems. Patients with DM may develop different dreaded complications during their lifetime, one of which is limited joint mobility (LJM). Joint abnormalities and LJM are problems that can arise at disease onset, and progressively worsen together with the disease. Because LJM shares causal factors with other chronic diabetes-induced complications, its study has been considered useful for monitoring the risk of developing other chronic complications due to DM such as vascular disease or diabetic foot. Joint deficits have been investigated using several methods in populations of different ages and types of DM. As a result, its exact prevalence is still difficult to define which can hinder the definition of prevention strategies. The several studies carried out recently have underlined the relationship between joint mobility, glycemic control, and disease duration in addition to considering LJM as a major risk factor for the development of diabetic foot. More recently, it has been demonstrated that joint mobility can significantly improve after short-term exercise therapy protocols. Identifying the threshold values of joint mobility for the risk of developing foot ulcers has been an additional important result. Analyzing the history of the relationship between diabetes and LJM is essential for better understanding of its own complexity in order to define appropriate prevention and treatment.