Physical assessment

The deformity and muscle spasm evaluation was made by the tests of Thomas and Galeazzi²⁷. The evaluation of the patellar and calcaneal reflexes was performed using a reflex hammer, and these were classified as absent, decreased, normal, or increased. The tactile sensitivity of the plantar surface of the foot was investigated by using the Semmes-Weinstein monofilaments, five monofilaments that bent when a force of 0.2, 2, 4, 10, and 300 g was used. The test was first performed with the blue monofilament (0.2 g) that was touched on 9 different areas of the feet (6 forefoot areas, 2 midfoot areas, and 1 hindfoot area), and then the subjects were asked to indicate when and where the touch occurred. Each monofilament was applied three times in the same area. The sensitivity threshold was defined as the lighter monofilament identified by the subject. When the threshold was greater than 2 g, the tactile sensitivity of the skin in this area was considered altered.