title: Sensory loss and walking speed related factors for gait alterations in patients with peripheral neuropathy.
abstract: BACKGROUND
  Walking instability and a higher risk of falls are common in patients with peripheral neuropathy. However, it remains uncertain as to whether alterations in neuropathic gait are directly related to deficient sensory locomotion control or due to a slowing of walking speed. By means of a multi-speed gait assessment we determined factors related to sensory loss and walking speed that cause changes in the gait pattern of neuropathic patients.
  
  
  METHODS
  Walking patterns of 18 neuropathic patients (70.7±2.4 years, 6 females) and 18 age- and gender-matched healthy subjects (70.4±2.4 years, 6 females) were recorded on a pressure-sensitive gait carpet for three different locomotion speeds (i.e. slow, preferred and fast) and while walking with eyes closed. Mean temporospatial gait parameters and gait variability were analyzed. The relationship between gait alterations and the history of falls in patients was evaluated.
  
  
  RESULTS
  Alterations in the mean locomotion pattern of neuropathic patients were mainly related to reduced walking speed. However, prolonged double support times (p<0.001), widened base widths (p=0.001) and increased gait variability (p<0.001) during slow walking or with eyes closed appeared to be directly linked to peripheral sensory loss in patients. Increased gait variability was predictive for the presence of self-reported falls in the past (p=0.029).
  
  
  CONCLUSIONS
  Sensory-loss-related prolongation of double support phases in neuropathic patients suggests a compensatory strategy to improve restabilization during locomotion. Moreover, widened base widths and increased gait variability point to an increased risk of falls. They occur primarily when patients are forced to reduce their walking speed or when visual feedback is disturbed.
authors.affiliation: University of Munich, German Center for Vertigo and Balance Disorders, Germany. Electronic address: mail@maxw.de.
authors.forename: Max
authors.initials: M
authors.lastname: Wuehr
authors.affiliation: University of Munich, German Center for Vertigo and Balance Disorders, Germany; University of Munich, Department of Neurology, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Schniepp
authors.affiliation: University of Munich, German Center for Vertigo and Balance Disorders, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Schlick
authors.affiliation: University of Munich, German Center for Vertigo and Balance Disorders, Germany.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Huth
authors.affiliation: University of Munich, German Center for Vertigo and Balance Disorders, Germany.
authors.forename: Cauchy
authors.initials: C
authors.lastname: Pradhan
authors.affiliation: University of Munich, German Center for Vertigo and Balance Disorders, Germany; University of Munich, Department of Neurology, Germany; University of Munich, Munich Center for Systems Neurology (SyNergy), Germany.
authors.forename: Marianne
authors.initials: M
authors.lastname: Dieterich
authors.affiliation: University of Munich, German Center for Vertigo and Balance Disorders, Germany; University of Munich, Institute for Clinical Neurosciences, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Brandt
authors.affiliation: University of Munich, German Center for Vertigo and Balance Disorders, Germany; University of Munich, Department of Neurology, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Jahn
mesh_terms: D000058:Accidental Falls; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008124:Locomotion / Q000502:physiology; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D012307:Risk Factors; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology*; D012683:Sensory Deprivation
keywords: Fall risk; Gait disorder; Gait variability; Peripheral neuropathy; Sensory feedback