Article

Patients with type II diabetes mellitus (DM) have been reported to be at high
risk of falls that may be further increased by the effects of challenging
activities such as obstacle-crossing. The purpose of this study was to compare
the end-point trajectory and joint kinematic and kinetic patterns of the lower
extremities between healthy subjects and individuals with DM during
obstacle-crossing with the leading limb. Fourteen patients with type II DM, with
no to minimal peripheral neuropathy (PN), and 14 healthy controls walked and
crossed obstacles of three different heights (10%, 20% and 30% of leg length)
while kinematic and kinetic data were measured using a motion analysis system and
two forceplates. Compared to normal, the DM group had similar walking speeds and
horizontal footobstacle distances but significantly reduced leading toe-obstacle
clearances, suggesting an increased risk of tripping over the obstacle. When the
swing toe was above the obstacle, the DM group showed greater pelvic anterior
tilt, stance ankle dorsiflexion, and smaller swing hip abduction,
with reduced
hip abductor moments but greater knee flexor and ankle plantarflexor and adductor
moments. It is suggested that patients with type II DM, with no or minimal PN,
should also be targeted for prevention of falls. Possible therapeutic
interventions to decrease falls for those with DM may include strengthening of
the knee flexors and ankle plantarflexor muscles, together with proprioception
and balance training.
CI - Copyright 2009. Published by Elsevier B.V.

Langue : ANGLAIS