Increased gait variability in diabetes mellitus patients with neuropathic pain.

Abstract

AIMS:

Gait dysfunction in subjects with diabetes mellitus (DM) contributes to falling and subsequent injuries. Using a portable device (GaitMeter™), we measured gait parameters in DM patients with and without diabetic peripheral neuropathy (DPN) during flat surface walking. We hypothesized that DM patients with DPN and neuropathic pain (NeP) would have greater gait step variability than those with DPN without NeP.

METHODS:

Subjects with DPN and at least moderate NeP (DPN-P), DPN without NeP (DPN-NoP), DM without DPN, and control subjects without DM were assessed. Our outcome measure was gait variability for step length and velocity. DPN severity was quantified using the Toronto Clinical Scoring System and the Utah Early Neuropathy Score. Falls and their outcomes were retrospectively quantified.

RESULTS:

Each cohort contained≥20 subjects. Durations of DM and HbA1C were greatest amongst DPN cohorts. DPN-P participants had greater variability of step length and step velocity, except for DM only participants. DPN-P participants also reported greater risk of hospitalizations for fall-related injuries, and greater fear of falling. Modest negative relationships emerged for step length with step velocity, reported falls and pain severity.

CONCLUSIONS:

NeP contributes to gait variability, potentially contributing to the risk of falling in DM patients.

• Authors: Paul Lalli, Ayechen Chan, Alexandra Garven, Nisha Midha, Cynthia Chan, Shauna Brady, Edward Block, Bin Hu, Cory Toth
• Journal: Journal of diabetes and its complications (J Diabetes Complications) 2013 May-Jun Vol. 27 Issue 3 Pg. 248-54 ISSN: 1873-460X [Electronic] United States
• PMID: 23218484 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Glycated Hemoglobin A
• hemoglobin A1c protein, human

Topics

• Accidental Falls
• Aged
• Alberta (epidemiology)
• Cohort Studies
• Cross-Sectional Studies
• Diabetic Nephropathies (blood, physiopathology)
• Female
• Gait Disorders, Neurologic (etiology, physiopathology)
• Glycated Hemoglobin (analysis)
• Hospitalization
• Humans
• Male
• Middle Aged
• Monitoring, Ambulatory
• Neuralgia (etiology, physiopathology)
• Retrospective Studies
• Risk Factors
• Severity of Illness Index
• Walking
• Wounds and Injuries (epidemiology, etiology, therapy)