Gait pattern alterations in older adults associated with type 2 diabetes in the absence of peripheral neuropathy--results from the Baltimore Longitudinal Study of Aging - PubMed (original) (raw)

Gait pattern alterations in older adults associated with type 2 diabetes in the absence of peripheral neuropathy--results from the Baltimore Longitudinal Study of Aging

Seung-uk Ko et al. Gait Posture. 2011 Oct.

Abstract

Diabetes may impact gait mechanics before onset of frank neuropathies and other associated threats to mobility. This study aims to characterize gait pattern alterations of type 2 diabetic adults without peripheral neuropathy during walking at maximum speed (fast-walking) as well as at self-selected speed (usual-walking). One-hundred and eighty-six participants aged 60-87 from the Baltimore Longitudinal Study of Aging (BLSA) able to walk unassisted and without peripheral neuropathy were classified as non-diabetic (N=160) or having type 2 diabetes (N=26). Gait parameters from the fast-walking and usual-walking tests were compared between participants with and without type 2 diabetes. Participants with diabetes had a shorter stride length for fast-walking (p=0.033) and a longer percentage of the gait cycle with the knee in 1st flexion for both fast- and usual-walking (p=0.033, and 0.040, respectively) than non-diabetic participants. Participants with diabetes exhibited a smaller hip range of motion in the sagittal plane during usual-walking compared to non-diabetics (p=0.049). During fast-walking, participants with diabetes used lower ankle generative mechanical work expenditure (MWE) and higher knee absorptive MWE compared to non-diabetic persons (p=0.021, and 0.018, respectively). These findings suggest that individuals with type 2 diabetes without overt peripheral neuropathy exhibit altered and less efficient gait patterns than non-diabetic persons. These alterations are more apparent during walking at a maximum speed indicating that maximum gait testing may be useful for identifying early threats to mobility limitations in older adults with type 2 diabetes.

Copyright © 2011 Elsevier B.V. All rights reserved.

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Figures

Figure 1

Figure 1

Correlation between ankle generative mechanical work expenditure (MWE) for ankle plantar flexion and knee absorptive MWE for knee flexion during late stance in the sagittal plane for fast-walking. Ankle generative MWE: ankle generative mechanical work expenditure for ankle plantar flexion during late stance in the sagittal plane Knee absorptive MWE: knee absorptive mechanical work expenditure for knee flexion during late stance in the sagittal plane

Figure 2

Figure 2

Prospected muscle activities for the rotations from knee and ankle during late stance period. knee in flexion: hamstring muscle, which is in contraction is omitted to emphasize dominant muscle activity of quadriceps

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