Interventions improve gait regularity in patients with peripheral neuropathy while walking on an irregular surface under low light.
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.
Richardson
James K
JK
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan 48109, USA. jkrich@umich.edu
Thies
Sibylle B
SB
DeMott
Trina K
TK
Ashton-Miller
James A
JA
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