Article

AIM: To investigate lower limb biomechanical strategy during stair walking in
patients with diabetes and patients with diabetic peripheral neuropathy, a
population known to exhibit lower limb muscular weakness. METHODS: The peak lower
limb joint moments of twenty-two patients with diabetic peripheral neuropathy and
thirty-nine patients with diabetes and no neuropathy were compared during ascent
and descent of a staircase to thirty-two healthy controls.
Fifty-nine of the
ninety-four participants also performed assessment of their maximum isokinetic
ankle and knee joint moment (muscle strength) to assess the level of peak joint
moments during the stair task relative to their maximal joint moment-generating
capabilities (operating strengths). RESULTS: Both patient groups ascended and
descended stairs slower than controls (p<0.05). Peak joint moments in patients
with diabetic peripheral neuropathy were lower (p<0.05) at the ankle and knee
during stair ascent, and knee only during stair descent compared to controls.
Ankle and knee muscle strength values were lower (p<0.05) in patients with
diabetic peripheral neuropathy compared to controls, and lower at knee only in
patients without neuropathy. Operating strengths were higher (p<0.05) at the
ankle and knee in patients with neuropathy during stair descent compared to the
controls, but not during stair ascent. CONCLUSION: Patients with diabetic
peripheral neuropathy walk slower to alter gait strategy during stair walking and
account for lower-limb muscular weakness, but still exhibit heightened operating
strengths during stair descent, which may impact upon fatigue and the ability to
recover a safe stance following postural instability.
CI - Copyright (c) 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Langue : ANGLAIS