title: Lower limb electromygraphy and kinematics of neuropathic diabetic patients during real-life activities: stair negotiation.
abstract: BACKGROUND
  In this study we investigate the influence of diabetic neuropathy (DN) on lower limb electromyography (EMG) and kinematics during stair negotiation.
  
  
  METHODS
  Forty-six adults (healthy and DN) performed stair ascent and descent tasks. Kinematic and EMG data were assessed unilaterally.
  
  
  RESULTS
  DN patients had lower ankle dorsiflexion while ascending and plantarflexion while descending. This reduced dorsiflexion compromises proper ankle and knee positions necessary for an efficient lifting action by the vastus lateralis (VL). The mechanical disadvantage of VL at the beginning of the stance triggered prolonged VL activation at the end of stair ascent. In stair descent, DN patients showed lower tibialis anterior activity in the early phase that can potentially impair the mechanism of impact absorption when the forefoot contacts the step.
  
  
  CONCLUSIONS
  Our results reveal an adaptive motor strategy in DN patients to overcome the challenge of stair ascent, which promoted more biomechanical deficits.
authors.affiliation: Centro de Docência e Pesquisa do Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, R. Cipotânea, 51, Cidade Universitária, 05360-160 São Paulo, Brazil.
authors.forename: Andrea N
authors.initials: AN
authors.lastname: Onodera
authors.forename: Aline A
authors.initials: AA
authors.lastname: Gomes
authors.forename: Denise
authors.initials: D
authors.lastname: Pripas
authors.forename: Rinaldo A
authors.initials: RA
authors.lastname: Mezzarane
authors.forename: Isabel C N
authors.initials: IC
authors.lastname: Sacco
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology; D001696:Biomechanical Phenomena / Q000502:physiology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D004576:Electromyography; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*