Diabetic Neuropathy and Gait: A Review.

Uazman Alam,Kristiaan D’Août,Rayaz A Malik,Shazli Azmi,Satyan Rajbhandari,David R Riley,Ravinder S Jugdey

doi:10.1007/s13300-017-0295-y

Abstract

Diabetic peripheral neuropathy (DPN) is a major sequela of diabetes mellitus and may have a detrimental effect on the gait of people with this complication. DPN causes a disruption in the body’s sensorimotor system and is believed to affect up to 50% of patients with diabetes mellitus, dependent on the duration of diabetes. It has a major effect on morbidity and mortality. The peripheral nervous system controls the complex series of events in gait through somatic and autonomic functions, careful balancing of eccentric and concentric muscle contractions and a reliance on the sensory information received from the plantar surface. In this literature review focussing on kinetics, kinematics and posture during gait in DPN patients, we have identified an intimate link between DPN and abnormalities in gait and demonstrated an increased risk in falls for older patients with diabetes. As such, we have identified a need for further research on the role of gait abnormalities in the development of diabetic foot ulceration and subsequent amputations.

Highlights

In this literature review focussing on kinetics, kinematics and posture during gait in Diabetic peripheral neuropathy (DPN) patients, we have identified an intimate link between DPN and abnormalities in gait and demonstrated an increased risk in falls for older patients with diabetes
We have identified a need for further research on the role of gait abnormalities in the development of diabetic foot ulceration and subsequent amputations
Diabetic peripheral neuropathy (DPN) is a symmetrical, length-dependent sensorimotor polyneuropathy which is attributed to metabolic and microvessel alterations due to hyperglycaemia and concomitant cardiovascular risk covariates [1]

Summary

Introduction

Diabetic peripheral neuropathy (DPN) is a symmetrical, length-dependent sensorimotor polyneuropathy which is attributed to metabolic and microvessel alterations due to hyperglycaemia and concomitant cardiovascular risk covariates [1]. In another study, intervention with pregabalin in painful diabetic neuropathy did not improve gait stability of the patients; rather, it caused increasing variability in gait speed and step length [43], possibly reflecting a higher risk of falling. Hazari et al [54] recently found no significant difference between the range of motion at the hip, knee or ankle joints when comparing patients with and without diabetic neuropathy.

Results

Conclusion