Assessment of Calf Muscle Flexibility and Trigger Points in Patients With Type 2 Diabetes
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Abstract
Background: Calf muscle flexibility is important for ankle mobility, gait, balance, and functional lower-limb performance, while myofascial trigger points may contribute to pain sensitivity, muscle tightness, and movement restriction. Patients with type 2 diabetes may be vulnerable to lower-limb musculoskeletal dysfunction because of metabolic, neuromuscular, and activity-related factors. Objective: To assess calf muscle flexibility and trigger points in patients with type 2 diabetes and determine the association between trigger-point palpation and goniometric flexibility categories. Methods: This cross-sectional observational study was conducted over six months at PSRD Hospital Lahore and Surayya Azeem Hospital Lahore. A total of 135 patients with type 2 diabetes were recruited through convenience sampling. Calf muscle flexibility was assessed using goniometric measurement, and trigger points in the gastrocnemius and soleus muscles were identified through manual palpation. Data were analyzed using SPSS version 27. Frequencies, percentages, means, and standard deviations were calculated, and chi-square testing was used to assess associations between trigger-point status and flexibility categories. Results: The mean age of participants was 42.19 ± 2.07 years. Most participants were female, married, obese, and had comorbidities. Trigger-point palpation was positive in 105 participants for both gastrocnemius and soleus muscles. Significant associations were found between trigger-point palpation and goniometric flexibility categories for both muscles (p<0.001). Conclusion: Trigger-point palpation was significantly associated with reduced calf muscle flexibility in patients with type 2 diabetes. These findings support combined assessment of myofascial trigger points and calf flexibility during lower-limb physiotherapy evaluation.
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