Diabetic patients with and without peripheral neuropathy reveal different hip and ankle biomechanical strategies during stair descent.
BACKGROUND
The progression of diabetes and the challenge of daily tasks may result in changes in biomechanical strategies. Descending stairs is a common task that patients have to deal with, however it still has not been properly studied in this population.


OBJECTIVE
We describe and compare the net joint moments and kinematics of the lower limbs in diabetic individuals with and without peripheral neuropathy and healthy controls during stair descent.


METHODS
Forty-two adults were assessed: control group (13), diabetic group (14), and neuropathic diabetic group (15). The flexor and extensor net moment peaks and joint angles of the hip, knee, and ankle were described and compared in terms of effect size and ANOVAs (p<0.05).


RESULTS
Both diabetic groups presented greater dorsiflexion [large effect size] and a smaller hip extensor moment [large effect size] in the weight acceptance phase. In the propulsion phase, diabetics with and without neuropathy showed a greater hip flexor moment [large effect size] and smaller ankle extension [large effect size].


CONCLUSIONS
Diabetic patients, even without neuropathy, revealed poor eccentric control in the weight acceptance phase, and in the propulsion phase, they showed a different hip strategy, where they chose to take the leg off the ground using more flexion torque at the hip instead of using a proper ankle extension function.
Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
Andreja P
AP
Picon
Cristina D
CD
Sartor
Maria I
MI
Roveri
Anice C
AC
Pássaro
Neli R
NR
Ortega
Isabel C N
IC
Sacco
D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology*