title: A comparison of gait characteristics between older women with and without peripheral neuropathy in standard and challenging environments.
abstract: OBJECTIVE
  To compare gait patterns in older women with and without peripheral neuropathy (PN) in standard (smooth surface, normal lighting) and challenging environments (CE) (irregular surface, low lighting).
  
  
  METHODS
  Observational, controlled study of 24 subjects.
  
  
  METHODS
  Biomechanical research laboratory.
  
  
  METHODS
  Twenty-four older women, 12 with PN and 12 without PN (mean age +/- standard deviation =67.1 +/- 7.9 and 70.2 +/- 4.3, respectively).
  
  
  METHODS
  Gait parameters and, in the 12 PN subjects, neuropathy severity.
  
  
  RESULTS
  The CE was associated with increases in step width, step-width variability, step-width range, step width-to-step length ratio, step time and step-time variability, and decreases in step length and speed. The PN subjects demonstrated a greater step width-to-step length ratio and step time and shorter step length and slower speed than the control subjects. In adapting to the CE, the PN subjects demonstrated greater increases in step width-to-step length ratio and step-time variability and a greater decrease in step length than did the control subjects. In the standard environment, only one gait parameter correlated with PN severity, whereas in the CE, four gait parameters did so.
  
  
  CONCLUSIONS
  The subjects demonstrated a gait that was slower, less efficient, and more variable temporally and in the frontal plane in the CE. Control and PN subjects demonstrated similar variability in medial-lateral step placement in the CE but at the cost of speed and efficiency for the PN subjects. Because the CE magnified gait differences between the two groups of subjects and caused gait changes in the PN subjects that correlated with PN severity, the CE may offer improved resolution for detecting gait abnormalities.
authors.affiliation: Departments of Physical Medicine and Rehabilitation and Mechanical Engineering, 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: D000058:Accidental Falls; D000367:Age Factors; D000368:Aged; D001696:Biomechanical Phenomena; D015992:Body Mass Index; D016022:Case-Control Studies; D004779:Environment Design; D005260:Female; D005430:Floors and Floorcoverings; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D015577:Geriatric Assessment; D006801:Humans; D008029:Lighting / Q000009:adverse effects; D015999:Multivariate Analysis; D010523:Peripheral Nervous System Diseases / Q000150:complications / Q000503:physiopathology; D004856:Postural Balance; D012307:Risk Factors; D012720:Severity of Illness Index; D013499:Surface Properties; D013997:Time Factors; D016138:Walking