Foot and Ankle Muscles Activation and Plantar Sensory Deficit in Leprosy and Its Implication to Foot Deformity and Walking Capacity

Objective: To observe extrinsic foot muscle activity ratio and sensory disturbance in Leprosy and its implication to foot deformity and walking capacity. Design: Cross sectional study in Singkawang, West Kalimantan. Materials and Methods: Thirty-three leprosy patients without walking aids and/or orthotic prosthetic were enrolled using consecutive sampling. Foot deformity score was calculated and muscle activity was measured using surface EMG. Muscle activation ratio was calculated in Tibialis anterior-to-Gastrocnemius (TA/GA) and Tibialis Anterior-to-Peroneal (TA/PE). Walking capacity was assessed using Timed up and Go test. Results: Significant differences of foot ulcer (p = 0.001) and foot deformities (p = 0.001) were found in plantar sensory deficit group. There was strong correlation between foot deformities and decreased TA/GA ratio (p = 0.001, r = ﹣0.787) and decreased TA/PE ratio (p = 0.001, r = ﹣0.663). There were significant differences of TA/GA ratio (p = 0.00) and TA/PE ratio (p = 0.09) based on the foot ulcer, and no significant difference of Timed Up and Go Test result within plantar sensory deficit group (p = 0.427). No significant correlation was found between walking capacity and TA/GA ratio (p = 0.055), and TA/PE ratio (p = 0.165). Conclusion: Plantar sensory deficit and decreased extrinsic muscle activation ratio during gait had been proven to affect foot impairment, but have not been proven to inhibit walking capacity.