GAIT ABNORMALITIES IN DIABETIC NEUROPATHY

OBJECTIVE - To investigate the effect of peripheral neuropathy on gait in diabetic patients. RESEARCH DESIGN AND METHODS - Gait analysis was performed in the following groups matched for age, sex, and BMI: 20 n ormal healthy control subjects (NC), 20 nonneuropathic diabetic contro l subjects (DC), 20 neuropathic diabetic subjects (DN), and 20 neuropa thic diabetic subjects with a history of foot ulceration (DNU). All su bjects with orthopedic foot problems were excluded from the study The following gait parameters were investigated: 1) walking speed; 2) stan ce phase duration; 3) joint angles and moment arms for the ankle. knee , and hip joints in both sagittal and frontal planes; 4) the component s of the ground reaction force (GRF) vector; and 5) the ankle, knee, a nd hip joint moments originating from the GRF vector in both planes. R ESULTS - There were no statistical differences in any of the parameter s studied between the NC and DC groups. Walking speed was significantl y slower in the DNU group compared with the two control groups (P < 0. 02). The maximum knee joint angle was smaller in the sagittal plane fo r the DNU group compared with the DC group values (P < 0.05). The maxi mum value of the vertical component of GRF was found to be higher (P < 0.03) in the two control groups compared with the DNU group. The maxi mum value of the anteroposterior forces was also found to be higher (P < 0.001) in the DC group compared with the DNU group. The maximum fro ntal plane ankle joint moment was significantly higher (P < 0.05) in t he DN compared with the NC group. CONCLUSIONS - Diabetic subjects with peripheral neuropathy demonstrate alterations in some gait parameters during walking. These alterations could facilitate fool injuries, thu s contributing to frequent foot ulceration.