title: Gait pattern alterations in older adults associated with type 2 diabetes in the absence of peripheral neuropathy--results from the Baltimore Longitudinal Study of Aging.
abstract: Diabetes may impact gait mechanics before onset of frank neuropathies and other associated threats to mobility. This study aims to characterize gait pattern alterations of type 2 diabetic adults without peripheral neuropathy during walking at maximum speed (fast-walking) as well as at self-selected speed (usual-walking). One-hundred and eighty-six participants aged 60-87 from the Baltimore Longitudinal Study of Aging (BLSA) able to walk unassisted and without peripheral neuropathy were classified as non-diabetic (N=160) or having type 2 diabetes (N=26). Gait parameters from the fast-walking and usual-walking tests were compared between participants with and without type 2 diabetes. Participants with diabetes had a shorter stride length for fast-walking (p=0.033) and a longer percentage of the gait cycle with the knee in 1st flexion for both fast- and usual-walking (p=0.033, and 0.040, respectively) than non-diabetic participants. Participants with diabetes exhibited a smaller hip range of motion in the sagittal plane during usual-walking compared to non-diabetics (p=0.049). During fast-walking, participants with diabetes used lower ankle generative mechanical work expenditure (MWE) and higher knee absorptive MWE compared to non-diabetic persons (p=0.021, and 0.018, respectively). These findings suggest that individuals with type 2 diabetes without overt peripheral neuropathy exhibit altered and less efficient gait patterns than non-diabetic persons. These alterations are more apparent during walking at a maximum speed indicating that maximum gait testing may be useful for identifying early threats to mobility limitations in older adults with type 2 diabetes.
authors.affiliation: Department of Mechanical Engineering, Chonnam National University, 50 Daehak-ro, Yeosu, Jeonnam, 550-749, South Korea. seunguk.ko@gmail.com
authors.forename: Seung-uk
authors.initials: SU
authors.lastname: Ko
authors.forename: Sari
authors.initials: S
authors.lastname: Stenholm
authors.forename: Chee W
authors.initials: CW
authors.lastname: Chia
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: D000368:Aged; D015142:Baltimore; D001696:Biomechanical Phenomena; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D005684:Gait / Q000502:physiology*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D016138:Walking / Q000502:physiology