PROBLEMS WITH GAIT AND POSTURE IN NEUROPATHIC PATIENTS WITH INSULIN-DEPENDENT DIABETES-MELLITUS
PROBLEMS WITH GAIT AND POSTURE IN NEUROPATHIC PATIENTS WITH INSULIN-DEPENDENT DIABETES-MELLITUS
复制标题
DOI：
10.1111/j.1464-5491.1992.tb01819.x
复制
发表时间：
1992-06-01
影响因子：
3.5
通讯作者：
ORCHARD, TJ
中科院分区：
文献类型：
--
作者：
CAVANAGH, PR;DERR, JA;ORCHARD, TJ
糖尿病继发的周围神经病变被认为会导致姿势不稳定和步态不协调，尽管这没有很好的记录。因此，对匹兹堡糖尿病并发症流行病学研究中的两组患者进行了调查，这两组患者的年龄和1型糖尿病的持续时间相匹配，但Vibratron 11测试确定的振动感觉阈值显著不同。神经病组和对照组的平均年龄分别为32.9岁和31.9岁，糖尿病持续时间分别为22.0年和18.8年。患者提供了跌倒损伤的详细信息，以及站立和行走时的安全感。多元线性和逻辑回归模型用于解释潜在相关变量，如性别、视网膜病变和糖尿病持续时间。相对于对照组，神经病组在步态期间报告的损伤的调整优势比为15.0（95%置信区间1.04-216.59）。神经病组还报告了在异常条件下感知安全性方面的得分显著低于对照组（不太安全，p = 0.004）。它的结论是周围神经病变的步态和姿势的影响，这是临床上有意义的，这种影响值得进一步的生物力学研究神经病患者。
Peripheral neuropathy secondary to diabetes mellitus is believed to cause postural instability and uncoordinated gait, although this is not well documented. Two groups of patients from the Pittsburgh Epidemiology of Diabetes Complications Study, matched for age and duration of Type 1 diabetes, but with significantly different vibratory sensation thresholds as determined by Vibratron 11 testing, were therefore surveyed. The mean ages were 32.9 and 31.9 years and durations of diabetes were 22.0 and 18.8 years for the neuropathic and control groups, respectively. Patients provided details of fall injuries, and perception of safety during standing and walking. Multiple linear and logistic regression models were used to account for potentially associated variables such as gender, retinopathy, and duration of diabetes. The neuropathic group had adjusted odds ratios for reported injuries during gait of 15.0 relative to the control group (95% confidence intervals 1.04-216.59). The neuropathic group also reported significantly lower scores (less safe, p = 0.004) than the control group on perceived safety in unusual conditions. It is concluded that peripheral neuropathy has an effect on gait and posture which is clinically significant and that this effect merits further biomechanical study in neuropathic patients.