title: Interventions improve gait regularity in patients with peripheral neuropathy while walking on an irregular surface under low light.
abstract: OBJECTIVE
  To determine which, if any, of three inexpensive interventions improve gait regularity in patients with peripheral neuropathy (PN) while walking on an irregular surface under low-light conditions.
  
  
  METHODS
  Observational.
  
  
  METHODS
  University of Michigan Biomechanics Research Laboratory.
  
  
  METHODS
  Forty-two patients with PN (20 women), mean age+/-standard deviation=64.5+/-9.7.
  
  
  METHODS
  A straight cane, touch of a vertical surface, or semirigid ankle orthoses.
  
  
  METHODS
  Step-width variability and range, step-time variability, and speed.
  
  
  RESULTS
  Subjects demonstrated significantly less step-width variability (mean=41.0+/-1.5, 36.9+/-1.6, 37.2+/-1.3, and 35.9+/-1.5 mm for baseline, cane, orthoses, and vertical surface, respectively; P<.0001) and range (182.7+/-7.4, 163.7+/-8.3, 164.3+/-7.4, 154.3+/-6.9 mm for baseline, cane, orthoses and vertical surface, respectively; P=.0006) with each of the interventions than under baseline conditions. Step-time variability significantly decreased with use of the orthoses and vertical surface but not the cane (P=.0001). Use of a cane, but not orthoses or vertical surface, was associated with decreased speed (0.79+/-0.03, 0.73+/-0.03, 0.79+/-0.03, 0.80+/-0.03 m/s for baseline, cane, orthoses, and vertical surface, respectively; P=.0001).
  
  
  CONCLUSIONS
  Older patients with PN demonstrate improved spatial and temporal measures of gait regularity with the use of a cane, ankle orthoses, or touch of a vertical surface while walking under challenging conditions. The decreased speed and stigma associated with the cane and uncertain availability of a vertical surface suggest that the ankle orthoses may be the most practical intervention.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan 48109, USA. jkrich@umich.edu
authors.forename: James K
authors.initials: JK
authors.lastname: Richardson
authors.forename: Sibylle B
authors.initials: SB
authors.lastname: Thies
authors.forename: Trina K
authors.initials: TK
authors.lastname: DeMott
authors.forename: James A
authors.initials: JA
authors.lastname: Ashton-Miller
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001294:Attitude to Health; D001696:Biomechanical Phenomena; D015992:Body Mass Index; D002183:Canes / Q000592:standards*; D005260:Female; D005684:Gait; D006801:Humans; D008029:Lighting / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices / Q000592:standards*; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology / Q000534:rehabilitation; D012720:Severity of Illness Index; D012727:Sex Characteristics; D013240:Stereotyping; D013499:Surface Properties; D013997:Time Factors; D014110:Touch; D016138:Walking; D016474:Weight-Bearing