Abstract
BackgroundIt is known that when barefoot, gait biomechanics of diabetic neuropathic patients differ from non-diabetic individuals. However, it is still unknown whether these biomechanical changes are also present during shod gait which is clinically advised for these patients. This study investigated the effect of the participants own shoes on gait biomechanics in diabetic neuropathic individuals compared to barefoot gait patterns and healthy controls.MethodsGround reaction forces and lower limb EMG activities were analyzed in 21 non-diabetic adults (50.9 ± 7.3 yr, 24.3 ± 2.6 kg/m2) and 24 diabetic neuropathic participants (55.2 ± 7.9 yr, 27.0 ± 4.4 kg/m2). EMG patterns of vastus lateralis, lateral gastrocnemius and tibialis anterior, along with the vertical and antero-posterior ground reaction forces were studied during shod and barefoot gait.ResultsRegardless of the disease, walking with shoes promoted an increase in the first peak vertical force and the peak horizontal propulsive force. Diabetic individuals had a delay in the lateral gastrocnemius EMG activity with no delay in the vastus lateralis. They also demonstrated a higher peak horizontal braking force walking with shoes compared to barefoot. Diabetic participants also had a smaller second peak vertical force in shod gait and a delay in the vastus lateralis EMG activity in barefoot gait compared to controls.ConclusionsThe change in plantar sensory information that occurs when wearing shoes revealed a different motor strategy in diabetic individuals. Walking with shoes did not attenuate vertical forces in either group. Though changes in motor strategy were apparent, the biomechanical did not support the argument that the use of shoes contributes to altered motor responses during gait.
Highlights
It is known that when barefoot, gait biomechanics of diabetic neuropathic patients differ from nondiabetic individuals
When examining stance phase time the results demonstrated that there was no significant difference between the groups for both gait conditions (CG × diabetic group (DG) shod p = 0.10; barefoot p = 0.33) This was performed to verify that both groups presented with similar gait cadence, once differences in stance phase could be caused by different cadences adopted by the subjects
Diabetic participants presented with a delayed vastus lateralis (VL) activity comparing to controls during barefoot gait (p = 0.005) which was found to be 3.5% of the stance phase (23 ms)
Summary
It is known that when barefoot, gait biomechanics of diabetic neuropathic patients differ from nondiabetic individuals. It is still unknown whether these biomechanical changes are present during shod gait which is clinically advised for these patients. All of the previously discussed gait alterations have been studied during barefoot gait, which does not represent the usual daily living locomotion condition, especially among diabetic individuals. It is still unknown if these biomechanical changes are present during shod gait, which is highly recommended for diabetic patients to prevent foot ulceration. The biomechanical adjustments during shod gait in patients with diabetic neuropathy are not yet clear
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
