title: Diabetic gait and posture abnormalities: a biomechanical investigation through three dimensional gait analysis.
abstract: BACKGROUND
  Diabetic sensorimotor polyneuropathy is a long-term diabetic complication. It is involved in the pathogenesis of the diabetic foot, which is a major cause of morbidity and mortality. The study aims to investigate the effects of diabetic polyneuropathy on gait and posture.
  
  
  METHODS
  Sixty seven subjects were enrolled: 21 diabetics without polyneuropathy, 26 with polyneuropathy, 20 controls (respectively, mean age 63.8 (SD 5.4), 63.2 (SD 5.6), 59.0 (SD 5.2) years, mean body mass index 26.3 (SD 2.5), 25.6 (SD 3), 24.0 (SD 2.9)). Postural and morphological evaluation and gait analysis were performed. Physical examination, together with a motion capture system synchronized with two force plates and two baropodometric systems were used. We evaluated lower limb mobility, foot deformities, trunk and pelvic posture, knee and heel position, plantar foot arch, three dimensional kinematics and kinetics during gait. The effect of peripheral vascular disease and microangiopathy on trunk and lower limb motion was also evaluated.
  
  
  RESULTS
  Trunk and lower limb joint mobility (in static and dynamic states) were more reduced in diabetics either with or without polyneuropathy on each plane; however in diabetics with polyneuropathy significantly lower ranges of motion were registered. Furthermore, both groups showed significant reductions in each joint moment and velocity (P0.003) during gait. In presence of both vasculopathy and microangiopathy a further significant reduction (P0.001) was noticed.
  
  
  CONCLUSIONS
  Altered gait and posture were found in diabetic patients irrespective of polyneuropathy. This approach may be relevant to predict the risk ulceration before clinically detectable neuropathy.
authors.affiliation: Department of Information Engineering, University of Padova, Padova, Italy. zimi.sawacha@dei.unipd.it
authors.forename: Zimi
authors.initials: Z
authors.lastname: Sawacha
authors.forename: Guarneri
authors.initials: G
authors.lastname: Gabriella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cristoferi
authors.forename: Annamaria
authors.initials: A
authors.lastname: Guiotto
authors.forename: Angelo
authors.initials: A
authors.lastname: Avogaro
authors.forename: Claudio
authors.initials: C
authors.lastname: Cobelli
mesh_terms: D003198:Computer Simulation; D003928:Diabetic Nephropathies / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D004856:Postural Balance