TY - JOUR
T1 - The impact of footwear and walking distance on gait stability in diabetic patients with peripheral neuropathy
AU - Najafi, Bijan
AU - Khan, Tahir
AU - Fleischer, Adam
AU - Wrobel, James
PY - 2013
Y1 - 2013
N2 - Background: We explored gait differences in patients with diabetes and peripheral neuropathy (DPN) and aged-matched controls over short and long walking distances. The potential benefit of footwear for improving gait in patients with DPN was also explored. Methods: Twelve patients with DPN and eight controls walked at their habitual speed over short (7 m) and long (20 m) distances under two conditions: barefoot and regular shoes. A validated system of body-worn sensors was used to extract spatiotemporal gait parameters. Neuropathy severity was quantified using vibratory perception threshold measured at the great toe. Results: Gait deterioration in the DPN group was observed during all of the walking trials. However, the difference between patients with DPN and participants in the control group achieved statistical significance only during long walking distance trials. Shod and barefoot double support times were longer in the DPN group during long walking distances (>20%, P =. 03). Gait unsteadiness, defined as coefficient of variation of gait velocity, was also significantly higher in the DPN group when barefoot walking over long distances (83%, P = .008). Furthermore, there was a high correlation between neuropathy severity and gait unsteadiness best demonstrated during the barefoot walking/long walking distance condition (r = 0.77, P < .001). The addition of footwear improved gait steadiness in the DPN group by 46% (P = .02). All differences were independent of age, sex, and body mass index (P > .05). Conclusions: This study suggests that gait alteration in patients with DPN is most pronounced while walking barefoot over longer distances and that footwear may improve gait steadiness in patients with DPN.
AB - Background: We explored gait differences in patients with diabetes and peripheral neuropathy (DPN) and aged-matched controls over short and long walking distances. The potential benefit of footwear for improving gait in patients with DPN was also explored. Methods: Twelve patients with DPN and eight controls walked at their habitual speed over short (7 m) and long (20 m) distances under two conditions: barefoot and regular shoes. A validated system of body-worn sensors was used to extract spatiotemporal gait parameters. Neuropathy severity was quantified using vibratory perception threshold measured at the great toe. Results: Gait deterioration in the DPN group was observed during all of the walking trials. However, the difference between patients with DPN and participants in the control group achieved statistical significance only during long walking distance trials. Shod and barefoot double support times were longer in the DPN group during long walking distances (>20%, P =. 03). Gait unsteadiness, defined as coefficient of variation of gait velocity, was also significantly higher in the DPN group when barefoot walking over long distances (83%, P = .008). Furthermore, there was a high correlation between neuropathy severity and gait unsteadiness best demonstrated during the barefoot walking/long walking distance condition (r = 0.77, P < .001). The addition of footwear improved gait steadiness in the DPN group by 46% (P = .02). All differences were independent of age, sex, and body mass index (P > .05). Conclusions: This study suggests that gait alteration in patients with DPN is most pronounced while walking barefoot over longer distances and that footwear may improve gait steadiness in patients with DPN.
UR - http://www.scopus.com/inward/record.url?scp=84883328319&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883328319&partnerID=8YFLogxK
U2 - 10.7547/1030165
DO - 10.7547/1030165
M3 - Article
C2 - 23697719
AN - SCOPUS:84883328319
SN - 8750-7315
VL - 103
SP - 165
EP - 173
JO - Journal of the American Podiatric Medical Association
JF - Journal of the American Podiatric Medical Association
IS - 3
ER -