Gait deviations.

Walking Biomechanics of Persons with Diabetes - A 3D Gait Analysis approach

Gait is influenced by peripheral circulation and neuro musculoskeletal system which can be affected by diabetes. Gait variations play an important role in increasing the peak plantar pressure in persons with diabetes. Biomechanical alterations in diabetic neuropathy could facilitate foot injuries, thus contributing to foot ulceration [1]. Understanding the gait characteristics in different category of diabetic population during walking can reveal the biomechanical factors which may collectively lead to foot pathology. 3-Dimensional (3D) Gait analysis was performed on 28 subjects with similar age, height, weight and Body Mass Index (BMI) (p > 0.05) with diabetes and without neuropathy (D), persons with diabetic neuropathy (DN) and persons who had a history of foot ulcer (DHU). Spatial and Temporal gait parameters along with kinematics and kinetics were compared between the three groups. The lower extremity gait data shows that DHU subjects show increased hip flexion throughout the gait cycle with delay in peak extension and DN subjects showing a slight delay in achieving peak hip extension. DHU show a significant deviation in hip, knee and ankle mechanics when compared to other two groups. There is a slight increase in dorsiflexion among diabetic subjects during the mid - stance phase. The ground reaction force (GRF) graphs shows that the breaking force and propelling force is less in magnitude for all the three groups when compared to normal. The vertical GRF data reveals there is no significant difference among the three groups but the graph shows delayed heel rocker during the gait. The compensation gait observed in DHU group may be due to the muscle weakness acquired in the past when there was active foot ulcer. This altered compensatory gait observed in DHU participants need to be addressed using proper corrective footwear and gait training sessions for preventing recurrence of ulcer. References [1] Katoulis EC, Ebdon-Parry M, Lanshammar H, Vileikyte L, Kulkarni J, Boulton AJM. Gait Abnormalities in Diabetic Neuropathy. Diabetes Care. 1997 Dec; 20(12): 1904-1907. Acknowledgements 1. M. V. Hospital for Diabetes, Royapuram, Chennai 2. CSIR – Central Leather Research Institute and Department of Science and Technology, India
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