The Evaluation of Gait and Balance for Patients with Early Diabetic Peripheral Neuropathy: A Cross-Sectional Study

Abstract

Objective Falls often occur in patients with diabetic neuropathy due to biomechanical alternation. The implication of diabetic peripheral neuropathy (DPN) on gait and balance remains poorly understood. Methods A total of 11 dynamic gait, balance and electrophysiological parameters were evaluated in 176 participants. The biomechanical parameters were compared between groups. Results Stride length and stride velocity were significantly lower in all subgroups of DPN compared with healthy subjects (p<0.05). Stance phase and double support phase were significantly higher, but swing phase were significantly lower across all subgroups of DPN than healthy subjects (p<0.05). Under eyes-open standing, the ML and AP range parameters of CoM sway, ankle sway and hip sway, CoM sway index, ankle swing index in both subclinical and confirmed DPN patients were all significantly higher compared to healthy subjects (p<0.05). Under eyes-closed standing, AP range parameters of CoM sway in subclinical DPN and confirmed DPN patients were significantly higher than healthy subjects (p<0.05). The hip sway areas in diabetics were significantly higher compared to healthy subjects (p<0.05). Conclusion The abnormal biomechanical parameters existed in the early stages of patients with DPN. The static balance under eyes-open and eye-closed condition is maintained by ankle joint compensation strategy and hip joint protection strategy. An early evaluation and better risk management is essential for diabetic patients with a history of more than 5 years even without DPN clinical symptoms and signs. Clinical Trial Registration Number No. ChiCTR1800019179, www.chictr.org.cn.

A Wearable Insole System to Measure Plantar Pressure and Shear for People with Diabetes

“…To our best knowledge, this is the first study that reports in-shoe real-time shear stress in two orthogonal directions, which could be potentially used to study balance in the medial–lateral direction as well as braking and propulsive impulses during gait [ 34 ]. These are critical parameters as understanding balance may help better manage the risks of loading asymmetry due to loss of movement control and localised stress distributions, all of which may lead to ulceration [ 35 ].…”

Effectiveness of Rebounder and Foot-ankle Exercises on Biomechanics and Quality of Life in Peripheral Neuropathy Patients

“…urrently, more than 500 million adults are living with diabetes worldwide, with nearly half of them suffering from various kinds of neuropathy [1][2][3][4]. In line with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), diabetes implications are growing rapidly and diabetic peripheral neuropathy (DPN) is the maximum common microvascular consequence, influencing as much as 70% of sufferers from diabetes [5].…”

Gait Analysis, Metabolic Parameters and Adherence to the Mediterranean Diet in Patients with Type 2 Diabetes Mellitus Compared with Healthy Controls: A Pilot Study

“…In DM patients, sensory impairment (presence of impaired vibration and protective sensation and/or neuropathic ulcer), reduced lower-extremity strength and central nervous system dysfunction may contribute to the development of gait disorders [8]. It has been suggested that impaired gait performance may be linked to the early stages of DPN in T2DM patients without clinical symptoms and signs of DPN [9]. Although gait abnormalities occur across the diabetes spectrum and worsen with disease severity, large fiber neuropathy occurs as an early silent symptom [10], and gait abnormalities rise with diabetes severity [11].…”