The effect of a cognitive or motor task on gait parameters of diabetic patients, with and without neuropathy

Abstract

with diabetes and no neuropathy (70 ± 2.9years). The temporal and spatial parameters of gait were evaluated using the GAITRite walkway. Subjects undertook four walks under normal walking conditions (single task); four times while simultaneously undertaking an additional motor task, carrying a tray with cups of water (dual task); and four times whilst undertaking a cognitive dual task, counting backwards in sevens. This arithmetic task was also completed in sitting.Results: For all gait variables there was a statistically significant difference between the groups. Subjects with DPN walked slower and with smaller steps compared to those with diabetes. In general the secondary task had a significant and adverse effect on the gait parameters and this effect was greater for those with DPN in both absolute and relative terms. Both groups had poorer arithmetic ability when walking compared to sitting. Discussion:Patients with DPN have different gait parameters to diabetic patients without neuropathy. Problems with divided attention when walking were more evident in the DPN group and may increase their risk of falls.

Risk Factors and Comorbidities in Diabetic Neuropathy: An Update 2015

“…Cognitive dysfunction is a further comorbidity that is being increasingly analyzed [123][124][125][126][127][128]. In the experimental model of DSPN, reduced pain perception may be associated with memory dysfunction [123].…”

Visual loss and falls: a review

“…The systemic manifestations of diabetes, the effects of lower limb neuropathy and any concurrent vascular disease may affect walking, gait and the risk of falls. 56 Glycaemic control itself can also affect the risk of falls. 57 As well as the visual disability caused by diabetes, pan-retinal photocoagulation does affect an individual's visual field and hence increase the risk of falls, however this has not been independently investigated.…”

Does Footwear Affect Balance?

“…18,19 Many participants disclosed various specific examples of how such functional changes caused the trip behind the fall. Although reasons mentioned for tripping could have resulted from the complications of diabetes and have been associated with an increased incidence of falls, not all of the participants seemed aware of a connection.…”

“…It is not possible to determine whether the weight issue was actual or perceived. However, for people with diabetes and neuropathy who are functionally impaired by lower-limb muscle weakness, 18,19 footwear weight may influence gait biomechanics. This previously unconsidered aspect of footwear design merits empirical evaluation.…”