A study of biomechanical parameters in gait analysis and sensitive cronaxie of diabetic neuropathic patients.
OBJECTIVE
The present investigation aims at studying the sensitive cronaxie in neuropathic and non-neuropathic diabetic patients as a measure of sensorial deficit. We seek to describe the gait using dynamic and temporal parameters. We have compared the results of the neuropathic patients to the results of a non-diabetic group. We have looked for relationships between peak plantar pressure and sensitive cronaxie in selected plantar areas.


METHODS
The experimental procedures were divided in: (a) determination of the sensitive cronaxie in four selected plantar areas, (b) determination and description of peak plantar pressure, ground reaction force variables and single and double stance time. We analyzed and compared the results of the sensitive cronaxie and the biomechanical parameters obtained by three experimental groups: diabetic, neuropathic and non-diabetic subjects.


RESULTS
The pathological response of the sensitive cronaxie worsened progressively for neuropathic and diabetic patients, respectively. Longer double and single stance times, lower minimum vertical force and lower growth rates were seen in the neuropathic patients when compared to diabetic and non-diabetic subjects.


CONCLUSIONS
These results indicate an alteration in the neuropathic patient movement structure. We have speculated that compensatory musculoskeletal mechanisms have been developed by neuropathic patients to compensate for their sensorial deficit. Future research is necessary to verify the relationship between neurophysiological and dynamic variables, since this relationship seems to be a good parameter for the interpretation and comprehension of the peripheral neuropathy. RelevancePeripheral neuropathy is one of the most insidious chronic complications of diabetes. It has been observed that dynamic changes in gait are usually associated with the peripheral neuropathy somatosensory deficits. Biomechanical studies have highlighted that dynamic gait evaluation can identify functional alterations, besides the analysis of sensitive cronaxie as a measure of sensorial deficits. They are also useful as a complimentary routine in the clinic treatment of diabetes and its further long-term complications.
Sacco
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School of Physical Education and Sport, University of Sao Paulo, Av. Prof. Mello Moraes, 65, Cidade Universitária, 05508-900, São Paulo, Brazil. icnsacco@usp.br
Amadio
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D000328:Adult; D001696:Biomechanical Phenomena; D003920:Diabetes Mellitus / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D004568:Electrodiagnosis; D005260:Female; D005528:Foot / Q000503:physiopathology*; D005534:Foot Diseases / Q000503:physiopathology; D005545:Forefoot, Human / Q000503:physiopathology; D005684:Gait / Q000502:physiology*; D006365:Heel / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology; D011312:Pressure; D012677:Sensation / Q000502:physiology*; D012678:Sensation Disorders / Q000503:physiopathology; D012684:Sensory Thresholds / Q000502:physiology; D013997:Time Factors; D016474:Weight-Bearing / Q000502:physiology