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Clinical factors associated with gait alterations in diabetic patients
Author(s) -
Allet L.,
Armand S.,
De Bie R. A.,
Golay A.,
Pataky Z.,
Aminian K.,
De Bruin E. D.
Publication year - 2009
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2009.02811.x
Subject(s) - medicine , gait , isometric exercise , diabetes mellitus , linear regression , physical medicine and rehabilitation , proprioception , preferred walking speed , physical therapy , endocrinology , machine learning , computer science
Abstract Aim To identify clinical factors associated with gait alterations in patients with Type 2 diabetes. Methods A sample of 76 diabetic patients underwent clinical examination and an outdoor gait assessment on tarred and cobblestoned terrains. We calculated respective differences in gait speed (performance measure) and gait variability (fall risk index) on changing terrains. Associations with clinical factors were investigated using correlation coefficients and linear regression analysis. Results The mean walking speed on the tarred pathway was 4.5 ± 0.6 km/h and 3.9 ± 0.8 km/h on the cobblestone pathway ( P < 0.001). The CVGCT increased from 2.6 ± 0.9% on the tarred pathway to 5.1 ± 2.8% on the cobblestone pathway ( P < 0.001). Regression analysis showed that 36% of the decrease in gait speed was explained proportionally by the mean of maximal isometric lower limb strength (22.2%; P ≤ 0.01), fear of falls (7.4%; P ≤ 0.01) and participants’ perceived vibration threshold (6.4%; P ≤ 0.01). Moreover, mean maximal isometric strength explained 11.8% ( P ≤ 0.01) of the increase of the coefficient of variation of the gait cycle time when participants changed from tarred terrain to cobblestones. Conclusion This study indicated that both physiological (strength and proprioception) and cognitive–behavioural factors (fear of falls) should be considered when treating diabetic patients with gait alterations. Therapists should apply these findings when developing specific fall prevention and treatment programmes.