Diabetic Gait Is Not Just Slow Gait: Gait Compensations in Diabetic Neuropathy
Background. Neuropathic complications from diabetes mellitus affect multiple nerve types and may manifest in gait. However, gait compensations are still poorly understood, as narrow analyses and lack of speed controls have contributed to conflicting or equivocal results. Purpose. To evaluate gait me...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2019/4512501 |
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| author | Adrienne D. Henderson A. Wayne Johnson Sarah T. Ridge Jonathan S. Egbert Kevin P. Curtis Levi J. Berry Dustin A. Bruening |
| author_facet | Adrienne D. Henderson A. Wayne Johnson Sarah T. Ridge Jonathan S. Egbert Kevin P. Curtis Levi J. Berry Dustin A. Bruening |
| author_sort | Adrienne D. Henderson |
| collection | DOAJ |
| description | Background. Neuropathic complications from diabetes mellitus affect multiple nerve types and may manifest in gait. However, gait compensations are still poorly understood, as narrow analyses and lack of speed controls have contributed to conflicting or equivocal results. Purpose. To evaluate gait mechanics and energetics in diabetic peripheral polyneuropathy. Methods. Instrumented gait analysis was performed on 14 participants with diabetic peripheral polyneuropathy and 14 matched controls, walking at 1.0 m/s. A full-body model with a multisegment foot was used to calculate inverse dynamics and analyze sagittal plane metrics and time series waveforms across stance phase. Results. Alterations included increased hip and knee flexion in early stance followed by a prolonged hip extension moment in midstance. Late stance ankle dorsiflexion and power absorption were increased, and final push-off was delayed and truncated. Conclusion. A neuropathic diabetic gait shares important similarities to a mild crouch gait with weakness/dysfunction in the foot and ankle. This study highlights two main compensation mechanisms that have been overlooked in previous literature. First, increased triceps surae stretch in terminal stance may be used to increase proprioception and/or energy storage, while a prolonged hip extension moment in midstance compensates for a limited push-off. These result in an overall workload shift from distal to proximal joints. Clinical assessment, monitoring, and treatment of neuropathy may benefit by focusing on these specific functional alterations. |
| format | Article |
| id | doaj-art-76362fb48fd844d19a89df5a2eabe031 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-76362fb48fd844d19a89df5a2eabe0312025-02-03T01:06:47ZengWileyJournal of Diabetes Research2314-67452314-67532019-01-01201910.1155/2019/45125014512501Diabetic Gait Is Not Just Slow Gait: Gait Compensations in Diabetic NeuropathyAdrienne D. Henderson0A. Wayne Johnson1Sarah T. Ridge2Jonathan S. Egbert3Kevin P. Curtis4Levi J. Berry5Dustin A. Bruening6Exercise Sciences Department, Brigham Young University, Provo, UT, USAExercise Sciences Department, Brigham Young University, Provo, UT, USAExercise Sciences Department, Brigham Young University, Provo, UT, USAExercise Sciences Department, Brigham Young University, Provo, UT, USAExercise Sciences Department, Brigham Young University, Provo, UT, USACanyon Foot and Ankle, Spanish Fork, UT, USAExercise Sciences Department, Brigham Young University, Provo, UT, USABackground. Neuropathic complications from diabetes mellitus affect multiple nerve types and may manifest in gait. However, gait compensations are still poorly understood, as narrow analyses and lack of speed controls have contributed to conflicting or equivocal results. Purpose. To evaluate gait mechanics and energetics in diabetic peripheral polyneuropathy. Methods. Instrumented gait analysis was performed on 14 participants with diabetic peripheral polyneuropathy and 14 matched controls, walking at 1.0 m/s. A full-body model with a multisegment foot was used to calculate inverse dynamics and analyze sagittal plane metrics and time series waveforms across stance phase. Results. Alterations included increased hip and knee flexion in early stance followed by a prolonged hip extension moment in midstance. Late stance ankle dorsiflexion and power absorption were increased, and final push-off was delayed and truncated. Conclusion. A neuropathic diabetic gait shares important similarities to a mild crouch gait with weakness/dysfunction in the foot and ankle. This study highlights two main compensation mechanisms that have been overlooked in previous literature. First, increased triceps surae stretch in terminal stance may be used to increase proprioception and/or energy storage, while a prolonged hip extension moment in midstance compensates for a limited push-off. These result in an overall workload shift from distal to proximal joints. Clinical assessment, monitoring, and treatment of neuropathy may benefit by focusing on these specific functional alterations.http://dx.doi.org/10.1155/2019/4512501 |
| spellingShingle | Adrienne D. Henderson A. Wayne Johnson Sarah T. Ridge Jonathan S. Egbert Kevin P. Curtis Levi J. Berry Dustin A. Bruening Diabetic Gait Is Not Just Slow Gait: Gait Compensations in Diabetic Neuropathy Journal of Diabetes Research |
| title | Diabetic Gait Is Not Just Slow Gait: Gait Compensations in Diabetic Neuropathy |
| title_full | Diabetic Gait Is Not Just Slow Gait: Gait Compensations in Diabetic Neuropathy |
| title_fullStr | Diabetic Gait Is Not Just Slow Gait: Gait Compensations in Diabetic Neuropathy |
| title_full_unstemmed | Diabetic Gait Is Not Just Slow Gait: Gait Compensations in Diabetic Neuropathy |
| title_short | Diabetic Gait Is Not Just Slow Gait: Gait Compensations in Diabetic Neuropathy |
| title_sort | diabetic gait is not just slow gait gait compensations in diabetic neuropathy |
| url | http://dx.doi.org/10.1155/2019/4512501 |
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