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Walking strategy in diabetic patients with peripheral neuropathy
Claudia Giacomozzi1, Antonella Caselli, Velio Macellari
1Biomedical Engineering Laboratory, Istituto Superiore di Sanità, Rome, Italy. c.giacomozzi@yahoo.com
Diabetes Care
|July 30, 2002
Summary
Diabetic neuropathic patients alter their walking strategy, showing longer foot loading times and reduced center of pressure (COP) excursions. These gait changes in diabetic neuropathy patients are quantified, supporting a modified deambulatory approach.
Area of Science:
- Biomechanics of gait
- Diabetic neuropathy research
- Podiatry and foot loading analysis
Background:
- Diabetic neuropathic patients exhibit distinct foot loading patterns during gait.
- These peculiar patterns suggest a significant alteration in their deambulatory strategy.
Purpose of the Study:
- To investigate and quantify changes in foot loading patterns during gait in diabetic patients.
- To monitor the excursion of the center of pressure (COP) during gait to support the hypothesis of altered walking strategies.
Main Methods:
- Evaluated 21 healthy volunteers and 61 diabetic patients (27 without neuropathy, 19 with neuropathy, 15 with previous ulcer).
- Utilized a piezo-dynamometric platform to record foot-to-floor interaction.
- Measured loading time and instantaneous COP position during the stance phase of gait.
Main Results:
- Neuropathic patients displayed significantly longer loading times compared to controls.
- A clear decrease in COP excursion along both medio-lateral and longitudinal axes was observed in neuropathic groups.
- COP integrals were significantly reduced across all pathological diabetic groups.
Conclusions:
- Quantification of loading patterns and COP excursions confirms altered foot-to-floor interaction in diabetic neuropathic patients.
- Reduced COP excursions and altered loading times support the hypothesis of a modified walking strategy in peripheral neuropathy.