September 2011

Patients with diabetes exhibit gait deficits before neuropathy develops

In the moment: Gait

Type 2 diabetes results in less efficient gait mechanics well before patients develop frank neuropathy and other threats to mobility, according to research in the August issue of Gait & Posture.

Investigators for the Baltimore Longitudinal Study of Aging, an observational study of physiological and psychological aspects of aging conducted by the National Institute on Aging, tested 186 participants without peripheral neuropathy (26 had type 2 diabetes) under two walking conditions, maximum speed and a self-selected speed.

When walking at maximum speed, patients with diabetes had a shorter stride length (p=0.033) and used lower ankle generative mechanical work expenditure (MWE) and higher knee absorptive MWE than nondiabetic individuals (p=0.021 and 0.018, respectively). People with diabetes also spent a longer percentage of the gait cycle with the knee in first flexion for both conditions (p=0.033 and 0.040, respectively) and had a smaller hip range of motion in the sagittal plane in the self-selected speed condition (p=0.049).

The larger gait alterations associated with maximum-speed walking make gait testing at that speed a useful tool for identifying early deficits, the authors wrote.

By Emily Delzell

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