Comparison of foot segmental mobility and coupling during gait between patients with diabetes mellitus with and without neuropathy and adults without diabetes
Comparison of foot segmental mobility and coupling during gait between patients with diabetes mellitus with and without neuropathy and adults without diabetes
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DOI：
10.1016/j.clinbiomech.2013.06.008
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发表时间：
2013-08-01
影响因子：
1.8
通讯作者：
Staes, F.
中科院分区：
文献类型：
--
作者：
Deschamps, K.;Matricali, G. A.;Staes, F.
背景：糖尿病患者足部活动度的降低被认为是足部生物力学改变的一个关键因素。本研究的目的是在体内节段性足运动学和耦合糖尿病患者和无神经病变的控制adults.Methods：足部活动度的13例糖尿病患者神经病变，13例糖尿病患者无神经病变和13例非糖尿病的人进行了测量，使用一个集成的测量设置，包括足底压力平台和三维运动分析系统。在这项年龄、性别和步行速度匹配的比较研究中，使用单因素重复测量方差分析（ANOVA）分析了在步态周期的不同阶段使用Rizzoli多节足模型量化的运动范围差异。耦合进行了评估与交叉相关techniques.Findings：糖尿病的两个队列表现出显着较低的运动值相比，对照组。与无神经病变的糖尿病组相比，神经病变组的横向和矢状面运动主要受影响，运动范围值通常较低。在推进（两个糖尿病组）和摆动阶段（主要是糖尿病神经病变组）观察到最显着的变化。段之间的交叉相关性较低的趋势被观察到在队列与diabetes.Interpretation：我们的研究结果表明，在段运动学和耦合在步行过程中的糖尿病患者和无神经病变的改变。未来的研究应该整合其他生物力学测量，因为它被认为是提供额外的洞察神经和机械缺陷相关的糖尿病足。(C)2013爱思唯尔有限公司保留所有权利。
Background: Reduction in foot mobility has been identified as a key factor of altered foot biomechanics in individuals with diabetes mellitus. This study aimed at comparing in vivo segmental foot kinematics and coupling in patients with diabetes with and without neuropathy to control adults.Methods: Foot mobility of 13 diabetic patients with neuropathy, 13 diabetic patients without neuropathy and 13 non-diabetic persons was measured using an integrated measurement set-up including a plantar pressure platform and 3D motion analysis system. In this age-, sex- and walking speed matched comparative study; differences in range of motion quantified with the Rizzoli multisegment foot model throughout different phases of the gait cycle were analysed using one-way repeated measures analysis of variance (ANOVA). Coupling was assessed with cross-correlation techniques.Findings: Both cohorts with diabetes showed significantly lower motion values as compared to the control group. Transverse and sagittal plane motion was predominantly affected with often lower range of motion values found in the group with neuropathy compared to the diabetes group without neuropathy. Most significant changes were observed during propulsion (both diabetic groups) and swing phase (predominantly diabetic neuropathic group). A trend of lower cross-correlations between segments was observed in the cohorts with diabetes.Interpretation: Our findings suggest an alteration in segmental kinematics and coupling during walking in diabetic patients with and without neuropathy. Future studies should integrate other biomechanical measurements as it is believed to provide additional insight into neural and mechanical deficits associated to the foot in diabetes. (C) 2013 Elsevier Ltd. All rights reserved.