Muscle strength and ankle mobility for the gait parameters in diabetic neuropathies

Martinelli, Alessandra Rezende; Mantovani, Alessandra Madia; Nozabieli, Andréa Jeanne Lourenço; Ferreira, Dalva Minonroze Albuquerque; Barela, José Ângelo; Camargo, Marcela Regina de; Fregonesi, Cristina Elena Prado Teles

doi:10.1016/j.foot.2012.11.001

Cited by 55 publications

(50 citation statements)

References 25 publications

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“…The causes could be related to the fact that diabetic individuals, especially those with greater levels of complications, present a shorter stride length and a longer cycle time when compared with healthy subjects, thus agreeing with other studies 4,20,22 . Furthermore, with respect to velocity, it was noted that the lower values found in the NG and NVG groups were inversely related to the double support/single support ratio.…”

Section: Discussionsupporting

confidence: 90%

“…This fact can be explained by increased double support values associated with decreased single support values, confirming the difficulty in maintaining the gait swing phase, which may indicate a balance deficit and hence, a greater risk of falling 18,19 . A previous study found a longer period of support in the gait of patients with DPN, suggesting that this was due to the generation of compensatory mechanisms of a musculoskeletal nature, as well as finding aggravations of other variables related to gait 4 . However, the present data showed that this condition was significant only in the NVG; therefore, it is probable that the individuals in the NG group have developed a compensatory mechanism during gait that favors the space-time variables, among them, velocity that may represent a considerable tool; however, not the NVG individuals.…”

Section: Discussionmentioning

confidence: 88%

“…When associated with vascular impairment of the lower limbs, this generates a set of changes in the feet, characterized as diabetic foot 2 . Over the course of the disease, there may be deformations, decreased mobility, and muscle hypotrophism of the foot and ankle, resulting in changes in plantar pressure and thus predisposing the individual to the development of ulcers and the risk of falls [3][4][5][6] . This, added to deficits in the motor control system, intensifies the imbalances and alterations in posture and gait 3 .…”

Section: Introductionmentioning

confidence: 99%

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Vasculopathy associated with peripheral neuropathy in gait parameters of diabetic people

Mantovani

Savian

Palma

et al. 2016

Motriz: rev. educ. fis.

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-Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus when glycemic levels are poorly controlled. Sometimes DPN is accompanied by vasculopathy (DPV), which can worsen the clinical prognosis. The aim of this study was to analyze the gait parameters of nondiabetic individuals and diabetic individuals with DPN with or without DPV. Method: The study included 68 individuals (50 to 65 years old) divided into three groups: people without diabetes mellitus (n = 33), diabetic patients with DPN (n = 18), and diabetic patients with both DPN and DVP (n = 17). The participants underwent a gait evaluation using electronic baropodometry to obtain the single and double support, velocity, and pressure-time integral. Results: The pressure-time integral, velocity, and single support variables were lower, and the double support and double support/single support ratio were higher in the diabetic neuropathy and vasculopathy group. The velocity was lower the greater the degree of impairment of the diabetic foot. Some correlations were identified with velocity. Conclusion: In diabetic individuals, there was a significant worsening of the gait parameters analyzed according to increasing degree of clinical impairment.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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Vasculopathy associated with peripheral neuropathy in gait parameters of diabetic people

Mantovani

Savian

Palma

et al. 2016

Motriz: rev. educ. fis.

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“…3,4,21 In another study neuropathic patients free of other infirmities, such as in the present study, showed alterations in their gait style, probably due to deficient motor innervation of the muscles associated with the development of the step, especially the dorsal and plantar flexors of the feet. 20,22 Sensory losses can jeopardize the proprioceptive mechanisms of plantar overload and increasingly compromise, among other factors, the gait parameters. 23 Cutaneous plantar sensory feedback is integrated at all levels into the central nervous system during motor neural control of the gait and posture via transcortical passages and mediated by the spinal oligosynaptic pathway.…”

Section: Discussionmentioning

confidence: 99%

“…19 To evaluate the balance under static conditions, the anteroposterior sway of the ankle was analyzed by measuring the angular variations with a kinematic system. 20 Two cameras were used for this, with a sampling rate of 60 Hz and with reflective markers affixed at pre-established anatomical points.…”

Section: Evaluations and Equipmentmentioning

confidence: 99%

Changes of the gait parameters and sensory-motor deficit associated with peripheral diabetic neuropathy

Martinelli¹,

Mantovani²,

Nozabieli³

et al. 2014

Acta Fisiátrica

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Peripheral nervous system impairment, with sensory and motor loss, as observed in diabetic neuropathy, can induce serious effects on balance control and gait in this population. Objective: To evaluate the performance of the gait and the sensory-motor changes, stemming from peripheral diabetic neuropathy (PDN). Method: Twenty-four individuals with PDN participated along with twenty-eight healthy individuals with no glycemic alterations indicative of diabetes. Participants were first subjected to clinical evaluations to confirm the clinical diagnosis of diabetic neuropathy by testing the tactile sensitivity of the soles of the feet with a monofilament test. Subsequently, ankle angle variations in static posture and during the gait were investigated through kinematics. The ankle muscle strength was investigated using a digital dynamometer. Results: The diabetic neuropathy group showed longer duration in double support and full support periods of gait than the control group, confirming greater difficulty in dynamic balance for these individuals. The group with neuropathy demonstrated reduced muscle strength, as much in the dorsiflexors as in the plantar flexors of the ankle. Conclusion: The sensory-motor losses stemming from PDN may cause impairment in gait performance, with consequent loss of balance.Keywords: Gait, Muscle Strength, Postural Balance, Diabetic Neuropathies RESUMOQuando há dano no sistema nervoso periférico, com prejuízos sensoriais e motores, como observado em neuropatas diabéticos, podem ocorrer graves repercussões sobre o equilíbrio e a locomoção nesta população. Objetivo: Avaliar o desempenho da marcha e alterações sensório-motoras, decorrentes da neuropatia diabética periférica. Método: Participaram 24 indivíduos neuropatas diabéticos e 28 indivíduos saudáveis sem alterações glicêmicas indicativas de diabete. Os participantes foram submetidos inicialmente a avaliações clínicas para confirmação de diagnóstico de neuropatia diabética por meio de teste de sensibilidade tátil da sola dos pés com monofilamentos. Posteriormente, foram submetidos à avaliação da variação angular do tornozelo, em condição estática e durante a marcha, por meio de cinemetria. A força muscular do tornozelo foi investigada por meio de dinamometria digital. Resultados: Foi demonstrado maior duração nos períodos de duplo apoio e apoio total da marcha em indivíduos com neuropatia diabética quando comparados com o grupo controle, confirmando uma maior dificuldade no equilíbrio dinâmico destes indivíduos. Para o grupo experimental de indivíduos neuropatas foi evidenciado redução da força muscular, tanto para os músculos dorsiflexores, quanto para os plantiflexores de tornozelo. Conclusão: As perdas sensório-motoras decorrentes da NDP podem implicar em prejuízo no desempenho da marcha, com consequente perda de equilíbrio.

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Motor Neuropathy in Diabetes

Khan

Andersen

2023

Contemporary Diabetes

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Muscle strength and ankle mobility for the gait parameters in diabetic neuropathies

Cited by 55 publications

References 25 publications

Vasculopathy associated with peripheral neuropathy in gait parameters of diabetic people

Vasculopathy associated with peripheral neuropathy in gait parameters of diabetic people

Changes of the gait parameters and sensory-motor deficit associated with peripheral diabetic neuropathy

Motor Neuropathy in Diabetes

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