Effect of joint limitation and balance control on gait changes in diabetic peripheral neuropathy.

IF 1.3 Q4 ENDOCRINOLOGY & METABOLISM Diabetology International Pub Date : 2023-07-24 eCollection Date: 2023-10-01 DOI:10.1007/s13340-023-00647-9

Hiroyuki Yamasaki, Yoshiro Abe, Shunsuke Mima, Mayu Bando, Shinji Nagasaka, Yutaro Yamashita, Kazuhide Mineda, Akio Kuroda, Munehide Matsuhisa, Masahiro Takaiwa, Ichiro Hashimoto

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Abstract

Aims: This study analyzed the gait patterns of diabetic peripheral neuropathy (DPN) patients and changes in the center of mass sway to prevent the formation and recurrence of foot ulcers.

Methods: Forty-two subjects were divided into the diabetes mellitus (DM), DPN, and diabetic foot ulcer (DFU) groups. We measured the range of motion (ROM) of the lower limb joints in the resting position and the center of mass sway in the standing position. Joint angles, ROM during walking, and distance factors were evaluated.

Results: In the DFU group, ROM limitation during walking was detected at the knee joint, and functional and ROM limitations were found at the ankle joint. The step length ratio and step width in the DFU group were significantly lower and higher than those in the DM group, respectively. The sway distances in the DFU group were greater than those in the DM and DPN groups.

Conclusions: Functional joint limitations and gait changes due to the decreased ability to maintain the center of gravity were observed in the DFU group. As DPN progressed, the patients' gait became small, wide, and shuffled. Thus, supporting joint movement during walking may help reduce the incidence and recurrence of foot ulcers.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-023-00647-9.

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关节限制和平衡控制对糖尿病周围神经病变步态变化的影响。

目的：本研究分析糖尿病周围神经病变（DPN）患者的步态模式和重心摆动的变化，以防止足部溃疡的形成和复发。方法：将42例受试者分为糖尿病（DM）组、糖尿病足溃疡（DFU）组。我们测量了静息姿势下下肢关节的运动范围（ROM）和站立姿势下重心的摆动。评估关节角度、行走过程中的ROM和距离因素。结果：在DFU组中，在膝关节处检测到行走过程中的ROM限制，在踝关节处发现功能和ROM限制。DFU组的步长比和步长分别显著低于DM组和DM组。DFU组的摆动距离大于DM和DPN组。结论：DFU组由于维持重心能力下降而出现功能性关节限制和步态变化。随着DPN的进展，患者的步态变得小、宽、乱。因此，在步行过程中支持关节运动可能有助于减少足部溃疡的发生率和复发率。补充信息：在线版本包含补充材料，可访问10.1007/s13340-023-00647-9。

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来源期刊

Diabetology International ENDOCRINOLOGY & METABOLISM-

CiteScore

3.90

自引率

4.50%

发文量

期刊介绍： Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.