Intralimb Coordination Patterns in Absent, Mild, and Severe Stages of Diabetic Neuropathy: Looking Beyond Kinematic Analysis of Gait Cycle

Autor(es)

Yi, Liu Chiao ^[1] ; Sartor, Cristina D. ^{[1, 2]} ; Souza, Francis Trombini ^[3] ; Sacco, Isabel C. N. ^[2]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo, Santos - Brazil

^[2] Univ Sao Paulo, Phys Therapy Speech & Occupat Therapy Dept, Sao Paulo - Brazil

^[3] Univ Pernambuco, Dept Phys Therapy, Petrolina - Brazil

• Tipo de documento: Artigo Científico
• Fonte: PLoS One; v. 11, n. 1 JAN 25 2016.
• Citações Web of Science: 4

Resumo

Aim Diabetes Mellitus progressively leads to impairments in stability and joint motion and might affect coordination patterns, mainly due to neuropathy. This study aims to describe changes in intralimb joint coordination in healthy individuals and patients with absent, mild and, severe stages of neuropathy. Methods Forty-seven diabetic patients were classified into three groups of neuropathic severity by a fuzzy model: 18 without neuropathy (DIAB), 7 with mild neuropathy (MILD), and 22 with moderate to severe neuropathy (SVRE). Thirteen healthy subjects were included as controls (CTRL). Continuous relative phase (CRP) was calculated at each instant of the gait cycle for each pair of lower limb joints. Analysis of Variance compared each frame of the CRP time series and its standard deviation among groups (alpha = 5%). Results For the ankle-hip CRP, the SVRE group presented increased variability at the propulsion phase and a distinct pattern at the propulsion and initial swing phases compared to the DIAB and CTRL groups. For the ankle-knee CRP, the 3 diabetic groups presented more anti-phase ratios than the CTRL group at the midstance, propulsion, and terminal swing phases, with decreased variability at the early stance phase. For the knee-hip CRP, the MILD group showed more in-phase ratio at the early stance and terminal swing phases and lower variability compared to all other groups. All diabetic groups were more in-phase at early the midstance phase (with lower variability) than the control group. Conclusion The low variability and coordination differences of the MILD group showed that gait coordination might be altered not only when frank evidence of neuropathy is present, but also when neuropathy is still incipient. The ankle-knee CRP at the initial swing phase showed distinct patterns for groups from all degrees of neuropathic severity and CTRLs. The anklehip CRP pattern distinguished the SVRE patients from other diabetic groups, particularly in the transitional phase from stance to swing. (AU)

• Processo FAPESP: 13/01941-3 - Análise das relações biomecânicas da cadeia cinética de membro inferior em diferentes populações com alterações na marcha
• Beneficiário: Liu Chiao Yi
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
• Processo FAPESP: 14/04997-2 - Análise biomecânica do mecanismo de ação de um calçado minimalista na diminuição de sobrecarga articular de idosas com osteoartrite de joelho
• Beneficiário: Francis Trombini de Souza
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado