Balance and ankle muscle strength predict spatiotemporal gait parameters in individuals with diabetic peripheral neuropathy

People with diabetic peripheral neuropathy (DPN) experience lower quality of life caused by associated balance, posture, and gait impairments. While focal muscle vibration (FMV) has been associated with improvements in gait performance in individuals with neurological disorders, little is known about its effectiveness in patients with DPN. The purpose of this study was to investigate the effect of FMV on gait outcomes in patients with DPN. The authors randomized 23 participants into three FMV intervention groups depending upon the delivery of vibration. Participants applied wearable FMV to the bilateral quadriceps, gastrocnemius, and tibialis anterior, 10 min per muscle, three times per week over a four-week period. Spatiotemporal, kinematic, and kinetic gait parameters at baseline and post-intervention were calculated and analyzed. Gait speed, cadence, stride time, left and right stance time, duration of double limb support, and left and right knee flexor moments significantly improved after four weeks of FMV. Trends toward significant improvements were noted in maximum left and right knee flexion. Results indicate that FMV therapy was associated with improvements in gait parameters in individuals with DPN, warranting expanded study of FMV therapy for long-term gait performance improvement in these individuals.

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Dual-Tasking Effects on Gait and Turning Performance of Stroke Survivors with Diabetic Peripheral Neuropathy

Malaysian Journal of Medical Sciences ◽

10.21315/mjms2021.28.2.6 ◽

2021 ◽

Vol 28 (2) ◽

pp. 63-71

Author(s):

Kamaruzaman Tajuddin ◽

Maria Justine ◽

Nadia Mohd Mustafah ◽

Lydia Latif ◽

Haidzir Manaf

Keyword(s):

Peripheral Neuropathy ◽

Diabetic Peripheral Neuropathy ◽

Cross Sectional Study ◽

Stroke Survivors ◽

Timed Up And Go ◽

Cross Sectional ◽

Dual Tasking ◽

Mixed Analysis ◽

Gait Parameters ◽

Main Effects

Background: Stroke survivors depend on the unaffected leg during walking and standing. The presence of diabetic peripheral neuropathy (DPN) affecting both legs may further affect the postural balance and gait instability and increase the risk for falls in such patients. Thus, this study was conducted to investigate the effect of dual taskings on the gait and turning performance of stroke survivors with DPN. Methods: Forty stroke survivors were recruited (20 with DPN and 20 without DPN) in this cross-sectional study design. Instrumented timed up and go (iTUG) tests were conducted in three different tasking conditions (single task, dual motor and dual cognitive). APDM® Mobility Lab system was used to capture the gait parameters during the iTUG tests. A two-way mixed analysis of variance was used to determine the main effects of gait performance on three taskings during the iTUG test. Results: Spatiotemporal gait parameters and turning performance (turning time and turning step times) were more affected by the tasking conditions in stroke survivors with DPN compared to those without DPN (P < 0.05). Conclusion: Stroke survivors with DPN had difficulty walking while turning and performing a secondary task simultaneously.

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Analysis of kinematic gait parameters in stroke with diabetic peripheral neuropathy (DPN)

2016 IEEE Conference on Systems, Process and Control (ICSPC) ◽

10.1109/spc.2016.7920718 ◽

2016 ◽

Author(s):

Nurhazwani Anang ◽

Rozita Jailani ◽

Nooritawati Md Tahir ◽

Haidzir Manaf ◽

Nadia Mustafah

Keyword(s):

Peripheral Neuropathy ◽

Diabetic Peripheral Neuropathy ◽

Gait Parameters

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The Impact of Diabetic Peripheral Neuropathy on Spatiotemporal Gait Parameters in Stroke Survivors: A Case-Control Study

Sains Malaysiana ◽

10.17576/jsm-2021-5001-19 ◽

2021 ◽

Vol 50 (1) ◽

pp. 191-199

Author(s):

Amirah Mustapa ◽

Maria Justine ◽

Nadia Mohd Mustafah ◽

Haidzir Manaf

Keyword(s):

Peripheral Neuropathy ◽

Diabetic Peripheral Neuropathy ◽

Case Control Study ◽

Case Control ◽

Stroke Survivors ◽

Healthy Controls ◽

Gait Performance ◽

Functional Balance ◽

Gait Parameters ◽

Control Study

The deterioration of gait performance following stroke is related to the impairment of sensorimotor function on the paretic side. Improper gait performance in post-stroke with additional diabetic peripheral neuropathy (DPN) on paretic and non-paretic legs may create destabilizing effects, including serious injuries and falls. Therefore, this study aimed to investigate the effect of DPN on spatiotemporal gait parameters in stroke survivors and determine the correlation of movement functioning and functional balance post-stroke with gait parameters. Ten stroke survivors with DPN, 10 stroke survivors without DPN and 10 healthy controls participated in this case-control study. Movement functioning and functional balance were assessed before the actual testing. Spatiotemporal gait parameters were recorded using the Nexus Vicon motion analysis system. Kruskal-Wallis test was used to analyze the gait parameters and Spearman’s rank-order correlation coefficient was used to identify the correlation between variables. Results showed that stroke survivors with DPN had longer stride time (temporal gait parameter, p = 0.001), lower cadence (p = 0.001) and greater gait variability than those without DPN and the healthy controls. The gait parameters were significantly correlated with movement functioning and functional balance in stroke survivors with DPN (p < 0.05). These findings suggested that DPN possibly affected the gait parameters in stroke survivors. DPN could also play a role in movement functioning and functional balance in stroke survivors.

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Rehabilitation Interventions for Gait Problems in Patients With Diabetic Peripheral Neuropathy: A Scoping Review

Function and Disability Journal ◽

10.32598/fdj.3.21 ◽

2021 ◽

Vol 15 (3) ◽

pp. 131-140

Author(s):

Zahra Hassani ◽

◽

Hamid Reza Mokhtarinia ◽

Charles Philip Gabel ◽

◽

...

Keyword(s):

Peripheral Neuropathy ◽

Scoping Review ◽

Diabetic Peripheral Neuropathy ◽

Current Knowledge ◽

Grey Literature ◽

Assistive Devices ◽

Inclusion Criteria ◽

Gait Performance ◽

Hand Search ◽

Gait Parameters

Background and Objectives: Gait and balance disturbances are challenging conditions in patients with Diabetic Peripheral Neuropathy (DPN). The overall literary consensus is that rehabilitation interventions are effective in improving gait performance in this patient group. This review sought to highlight and assess the literature and provide a scoping review on the current knowledge gaps in the rehabilitation interventions for the gait problems of patients with DPN. Methods: An electronic databases search was done between 2001 and May 2020. Besides, a hand-search method was used for grey literature. Two experts reviewed the results and screened them based on the subject’s diagnosis with DPN and gait problems. Results: Of 87 studies obtained, nine met the inclusion criteria. The frequent components of the rehabilitation interventions included exercise therapy, dual-task intervention, and the use of assistive devices. The outcomes utilized most frequently included changes in balance and stability, muscle strength, proprioception, function, and gait parameters. Conclusion: Evidence was formed as a scoping review to guide rehabilitation for DPN patients with gait problems. Rigorous comparative studies with clearly defined interventions are needed.

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