title: Increased gait variability in diabetes mellitus patients with neuropathic pain.
abstract: OBJECTIVE
  Gait dysfunction in subjects with diabetes mellitus (DM) contributes to falling and subsequent injuries. Using a portable device (GaitMeter™), we measured gait parameters in DM patients with and without diabetic peripheral neuropathy (DPN) during flat surface walking. We hypothesized that DM patients with DPN and neuropathic pain (NeP) would have greater gait step variability than those with DPN without NeP.
  
  
  METHODS
  Subjects with DPN and at least moderate NeP (DPN-P), DPN without NeP (DPN-NoP), DM without DPN, and control subjects without DM were assessed. Our outcome measure was gait variability for step length and velocity. DPN severity was quantified using the Toronto Clinical Scoring System and the Utah Early Neuropathy Score. Falls and their outcomes were retrospectively quantified.
  
  
  RESULTS
  Each cohort contained≥20 subjects. Durations of DM and HbA1C were greatest amongst DPN cohorts. DPN-P participants had greater variability of step length and step velocity, except for DM only participants. DPN-P participants also reported greater risk of hospitalizations for fall-related injuries, and greater fear of falling. Modest negative relationships emerged for step length with step velocity, reported falls and pain severity.
  
  
  CONCLUSIONS
  NeP contributes to gait variability, potentially contributing to the risk of falling in DM patients.
authors.affiliation: Department of Clinical Neurosciences, the Hotchkiss Brain Institute and the University of Calgary, Calgary, AB, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Lalli
authors.forename: Ayechen
authors.initials: A
authors.lastname: Chan
authors.forename: Alexandra
authors.initials: A
authors.lastname: Garven
authors.forename: Nisha
authors.initials: N
authors.lastname: Midha
authors.forename: Cynthia
authors.initials: C
authors.lastname: Chan
authors.forename: Shauna
authors.initials: S
authors.lastname: Brady
authors.forename: Edward
authors.initials: E
authors.lastname: Block
authors.forename: Bin
authors.initials: B
authors.lastname: Hu
authors.forename: Cory
authors.initials: C
authors.lastname: Toth
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000416:Alberta / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003928:Diabetic Nephropathies / Q000097:blood / Q000503:physiopathology*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000503:physiopathology; D006442:Glycated Hemoglobin / Q000032:analysis; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D009437:Neuralgia / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016138:Walking; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology / Q000628:therapy
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human