D9. Gait Impairments Seen in Diabetic Neuropathy Patients after Surgical Intervention for Open Wounds

Abstract

PURPOSE: Identifying gait impairments at different levels of neuropathy guides clinicians to prophylactically treat neuropathy symptoms. This is the first large-scale study to quantify gait parameters based by degree of neuropathy. METHODS: Adults who could safely ambulate without pain, open wounds, and lower extremity surgery in the previous three months were offered participation. Participants completed a standardized 120-second walk test with wearable sensors at a self-selected pace. Levels of neuropathy in diabetic patients were defined as “0 = no neuropathy; 1 = neuropathy but no deformity; 2 = neuropathy with deformity (hammertoes, bunion, equinus, etc); 3 = neuropathy with history of an open wound that led to lower extremity surgical intervention. Data were collected and analyzed with Motility Lab software and STATA VSN 17.0 with significance defined as p < 0.05. RESULTS: Of the 135 patients included (56.79 + 16.55 years of age, BMI 28.78 kg/m2), 70 had neuropathy and 65 non-diabetic patients served as control. Linear regression modeling revealed patients with open wounds that led to surgery (Level 3) neuropathy were associated with poorer gait function in all parameters compared to non-diabetic controls (p<0.0001). Level 1 correlated with poorer gait speed, and single and double limb support (p<0.05). CONCLUSION: Neuropathic patients with chronic wounds requiring surgical intervention demonstrated gait dysfunction. Patients at risk of severe diabetic neuropathy should be counseled and supported to avoid further ambulatory impairment.