Article

It is advantageous from a rehabilitation standpoint to determine physiological
factors associated with functional gait. These factors may be fundamentally
different in those with peripheral neuropathy (PN) compared to age-matched
healthy individuals. The purpose of this investigation was to examine
associations between functional gait and measures of leg strength, standing
balance, and locomotor kinematics in people with and without PN. METHODS:
Individuals with PN and age-matched controls were assessed for functional gait by
the 6-min walk and timed up-and-go tests. Leg strength was measured as isokinetic
peak torque of the knee extensors. Standing balance was assessed by
center-of-pressure sway velocity and area during quiet stance. Locomotor
kinematics from treadmill walking were used to compute stride duration
variability and local instability (i.e., finite-time Lyapunov exponents), which
estimate kinematic divergence caused by small-scale perturbations. RESULTS: Leg
strength and locomotor kinematics - in particular local instability - correlated
with functional gait performance in controls. Conversely, reduced functional gait
performance in the PN group was primarily mediated by impaired standing balance
control. DISCUSSION: Locomotor kinematics predicts functional gait, and the
magnitude of variability and local instability should be calculated to fully
evaluate locomotor system health. The observation that different factors
associated with functional gait between groups speaks to the uniqueness of the
PN-related movement disorder. Functional gait-related rehabilitation programs for
PN patients should be tailored toward this uniqueness.

Langue : ANGLAIS