Diabetic Peripheral Neuropathy and Gait Stability



This research highlights the possibilities of using footwear to correct gait patterns in patients with diabetes and peripheral neuropathy (DPN).

For this purpose, Najafi et al. aged-matched a group of eight non diabetics with twelve patients, suffering with the nerve damaging disorder for at least three years.

A validated gait analyser system was used to assess participant gait by equipping subjects with five wearable sensors as they walked at their habitual speed for a short distance (7m) and a long distance (20m) in two conditions: barefoot and shod.

The three main hypotheses explored were: patients with DPN exhibit deteriorating gait, gait alterations become more pronounced over longer distances in patients with DPN and footwear can be used as a remedy to correct these gait alterations.

The DPN group showed significant gait deterioration while walking over long distances when compared to the control group.

Gait unsteadiness increased 83% (P = .008) in the DPN group during barefoot walking over long distances. A high correlation was observed between neuropathy severity and gait unsteadiness in this condition (r = 0.77, P < .001).

Gait initiation velocity (P < .005, 95% CI = 0.034 to 0.08m/sec) improved significantly by the addition of footwear along with gait steady state velocity (P < .01, 95% CI = 0.03 to 0.08 m/sec). The number of steps taken to achieve steadiness was reduced by wearing shoes (P = .05).

Najafi et al. were successful in clearly demonstrating the benefits of footwear in improving gait steadiness in patients with DPN and proposed future assessments of gait alterations of the same over longer walking distances (preferably > 20m).

References:

  1. Bijan Najafi, Tahir Khan, Adam Fleischer, James Wrobel (2013) The Impact of Footwear and Walking Distance on Gait Stability in Diabetic Patients with Peripheral Neuropathy. Journal of the American Podiatric Medical Association: May/June 2013, Vol. 103, No. 3, pp. 165-173.

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