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Intralimb Coordination Patterns in Absent, Mild, and Severe Stages of Diabetic Neuropathy: Looking Beyond Kinematic Analysis of Gait Cycle.
- Source :
-
PloS one [PLoS One] 2016 Jan 25; Vol. 11 (1), pp. e0147300. Date of Electronic Publication: 2016 Jan 25 (Print Publication: 2016). - Publication Year :
- 2016
-
Abstract
- Aim: Diabetes Mellitus progressively leads to impairments in stability and joint motion and might affect coordination patterns, mainly due to neuropathy. This study aims to describe changes in intralimb joint coordination in healthy individuals and patients with absent, mild and, severe stages of neuropathy.<br />Methods: Forty-seven diabetic patients were classified into three groups of neuropathic severity by a fuzzy model: 18 without neuropathy (DIAB), 7 with mild neuropathy (MILD), and 22 with moderate to severe neuropathy (SVRE). Thirteen healthy subjects were included as controls (CTRL). Continuous relative phase (CRP) was calculated at each instant of the gait cycle for each pair of lower limb joints. Analysis of Variance compared each frame of the CRP time series and its standard deviation among groups (α = 5%).<br />Results: For the ankle-hip CRP, the SVRE group presented increased variability at the propulsion phase and a distinct pattern at the propulsion and initial swing phases compared to the DIAB and CTRL groups. For the ankle-knee CRP, the 3 diabetic groups presented more anti-phase ratios than the CTRL group at the midstance, propulsion, and terminal swing phases, with decreased variability at the early stance phase. For the knee-hip CRP, the MILD group showed more in-phase ratio at the early stance and terminal swing phases and lower variability compared to all other groups. All diabetic groups were more in-phase at early the midstance phase (with lower variability) than the control group.<br />Conclusion: The low variability and coordination differences of the MILD group showed that gait coordination might be altered not only when frank evidence of neuropathy is present, but also when neuropathy is still incipient. The ankle-knee CRP at the initial swing phase showed distinct patterns for groups from all degrees of neuropathic severity and CTRLs. The ankle-hip CRP pattern distinguished the SVRE patients from other diabetic groups, particularly in the transitional phase from stance to swing.
- Subjects :
- Aged
Ankle Joint physiopathology
Biomechanical Phenomena
Body Mass Index
Diabetic Neuropathies pathology
Diabetic Neuropathies physiopathology
Female
Foot innervation
Foot pathology
Gait Disorders, Neurologic etiology
Hip Joint physiopathology
Humans
Hypesthesia etiology
Hypesthesia physiopathology
Knee Joint physiopathology
Male
Middle Aged
Movement
Physical Examination
Severity of Illness Index
Surveys and Questionnaires
Walking
Diabetic Neuropathies complications
Gait Disorders, Neurologic physiopathology
Leg physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 26807858
- Full Text :
- https://doi.org/10.1371/journal.pone.0147300