Abstract
BackgroundIt is known that general gait training improves lower extremity muscle strength and endurance in Diabetes Neuropathy (DN). But, it is still unknown whether Task-Oriented (TO) gait training would change gait biomechanics and the risk of falling in DN. TO gait training focuses on promoting timing and coordination of lower extremity movements through goal-directed practices with sufficient repetition.MethodsA group of 14 patients with DN participated in a time-series study. All subjects participated in four sessions of assessments (Initial, Pre, Post and Follow-Up). Training was twice a week for 12 weeks. Vertical and horizontal Ground Reaction Forces (GRF), Time Get up and Go (TGUG) and Fall Efficacy Scale-International (FES-I) were evaluated. Gait training started with stepping patterns that progressively changed to complicated patterns of walking. Then, training continued combining walking patterns with upper extremity activities and then ended with treadmill-paced practice.ResultsDN patients significantly increased Second Vertical Peak Force and Horizontal Propulsive Force in addition decrease in Minimum Vertical Force. TGUG significantly decreased while FES-I reflected significant increase after gait training.DiscussionConclusively, training not only improved gait performance, confidence in daily activities and attenuated risk of falling, but also helped DN patients to improve feet biomechanics, muscles timing and coordination.ConclusionsGait training with respect to principles of motor learning allowed patients to effectively improve through sessions.
Highlights
It is known that general gait training improves lower extremity muscle strength and endurance in Diabetes Neuropathy (DN)
Gait training with respect to principles of motor learning allowed patients to effectively improve through sessions
Difficulties in walking of Diabetes Neuropathy (DN) patients results in higher risk of falling and injuries [1]
Summary
It is known that general gait training improves lower extremity muscle strength and endurance in Diabetes Neuropathy (DN). It is still unknown whether Task-Oriented (TO) gait training would change gait biomechanics and the risk of falling in DN. Difficulties in walking of Diabetes Neuropathy (DN) patients results in higher risk of falling and injuries [1]. Some studies have reported common changes in gait parameters in DN patients including higher gait variability [6], longer stance phase [7] and slower speed of walking [8]. Kinetic parameters reported some changes such as modified Ground Reaction Forces (GRF) and moments of forces. Substitution of the vestibular system to control body orientation has some influences on the control of stability and balance during gait [14]
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