Abstract
Background and Objectives: Diabetes mellitus is considered a serious public health problem due to its high prevalence and related complications, including gait and posture impairments due to neuropathy and vascular alterations and the subsequent increased risk of falls. The gait of patients with diabetes is characterized by alterations of the main spatiotemporal gait parameters such as gait velocity, cadence, stride time and length, which are also known to worsen with disease course. Wearable sensor systems can be used for gait analysis by providing spatiotemporal parameters and postural control (evaluated from the perspective of body sway), useful for investigating the disease progression. Thanks to their small size and low cost of their components, inertial measurement units (IMUs) are easy to wear and are cheap tools for movement analysis. Materials and Methods: The aim of this study is to review articles published in the last 21 years (from 2000 to 2021) concerning the application of wearable sensors to assess spatiotemporal parameters of gait and body postural alterations in patients with diabetes mellitus. Relevant articles were searched in the Medline database using PubMed, Ovid and Cochrane libraries. Results: One hundred and four articles were initially identified while searching the scientific literature on this topic. Thirteen were selected and analysed in this review. Wearable motion sensors are useful, noninvasive, low-cost, and objective tools for performing gait and posture analysis in diabetic patients. The IMUs can be worn at the lumber levels, tibias or feet, and different spatiotemporal parameters of movement and static posture can be assessed. Conclusions: Future research should focus on standardizing the measurement setup and selecting the most informative spatiotemporal parameters for gait and posture analysis.
Highlights
Gait impairments such as poor balance, neuropathies and muscle weakness, either together or individually, are common among people with diabetes mellitus (DM), and can lead to gait abnormalities, including incorrect foot pressure distribution
We focus on inertial sensors for gait and posture analysis both outdoors or at home and in the clinical setting, to evaluate the possible application of these wearable sensors in the analysis of movement during tasks related to activities of daily living
The improvement in gait and postural alterations in diabetic patients with diabetic polyneuropathy (DPN) after plantar electrical stimulation observed with inertial measurement units (IMUs) [29] was not correlated with a similar improvement measured through the mobility tiredness scale, suggesting the changes induced by this intervention were likely to be small, or that IMUS analysis was more sensitive than the classical tools based on self-reported questionnaires. Both nervous and vascular alterations are significant long-term complications in patients with diabetes, and they account for significant morbidity and mortality and the risk of falls, so the evaluation of gait and posture in patients with DPN and vascular problems in feet, leading to alterations in biomechanical spatiotemporal variables of gait, is clinically important to diagnose and tailor interventions to reduce the adverse outcomes [42,43,44,45,46]
Summary
Gait impairments such as poor balance, neuropathies and muscle weakness, either together or individually, are common among people with diabetes mellitus (DM), and can lead to gait abnormalities, including incorrect foot pressure distribution. Wearable sensor systems can be used for gait analysis by providing spatiotemporal parameters and postural control (evaluated from the perspective of body sway), useful for investigating the disease progression. Thanks to their small size and low cost of their components, inertial measurement units (IMUs) are easy to wear and are cheap tools for movement analysis. Materials and Methods: The aim of this study is to review articles published in the last 21 years (from 2000 to 2021) concerning the application of wearable sensors to assess spatiotemporal parameters of gait and body postural alterations in patients with diabetes mellitus. Conclusions: Future research should focus on standardizing the measurement setup and selecting the most informative spatiotemporal parameters for gait and posture analysis
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