Abstract
Walking on irregular terrain influences gait of diabetic patients. We investigate the test-retest reliability and construct validity of gait measured with the DynaPort MiniMod under single and dual task conditions in diabetic patients walking on irregular terrain to identify the measurement error (precision) and minimal clinical detectable change. 29 patients with Type 2 diabetes were measured once, and 25 repeated the measurement within 7 days. Patients walked on a therapy garden walkway. Differences between three groups of diabetics with various levels of lower extremity neuropathy were analyzed with planned contrasts. ICC was excellent for intervisit measurements with ICC's >0.824. Bland and Altman Plots, SEM, and SDD showed precise values, distributed around zero for both test conditions. A significant effect of grouping on step length performance hints at possible construct validity of the device. Good reliability of DynaPort MiniMod measurements on a therapy garden walkway and an indication for discriminatory capability suggests that DynaPort MiniMod could facilitate the study of gait in diabetic patients in conditions close to real-life situations. Good reliability, small measurement error, and values of minimal clinical detectable change recommend the further utilization of DynaPort MiniMod for the evaluation of gait parameters in diabetic patients.
Highlights
The World Health Organization has described type 2 diabetes as an international epidemic
This study has shown that the reliability of walking speed, cadence, step duration and step length on different surfaces and under dual task conditions was high with excellent ICCs, small standard error of the measurement (SEM) and RLOAs in older adults with diabetes using the DynaPort MiniMod system
There are, only indications that the system might be able to distinguish between subpopulations within the population of patients with diabetes based on step length
Summary
The World Health Organization has described type 2 diabetes as an international epidemic. Because the increasing prevalence of diabetes is accompanied by gait problems and a heightened risk of falling, there is an increased need for understanding the possible gait pattern changes diabetic patients are confronted with [4]. It has, been demonstrated that patients with diabetes may improve their gait due to specific exercise programs [5, 6]. Gait analyses are traditionally performed indoors, on a predefined, clean, and flat specific pathway Such conditions enable precise recording but are not representative of the real-life context. The fact that falling mainly occurs in a complex environment [13] under
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