title: Motor strategy patterns study of diabetic neuropathic individuals while walking. A wavelet approach.
abstract: The aim of this study was to investigate muscle׳s energy patterns and spectral properties of diabetic neuropathic individuals during gait cycle using wavelet approach. Twenty-one diabetic patients diagnosed with peripheral neuropathy, and 21 non-diabetic individuals were assessed during the whole gait cycle. Activation patterns of vastus lateralis, medial gastrocnemius and tibialis anterior were studied by means of bipolar surface EMG. The signal׳s energy and frequency were compared between groups using t-test. The energy was compared in each frequency band (7-542 Hz) using ANOVAs for repeated measures for each group and each muscle. The diabetic individuals displayed lower energies in lower frequency bands for all muscles and higher energies in higher frequency bands for the extensors׳ muscles. They also showed lower total energy of gastrocnemius and a higher total energy of vastus, considering the whole gait cycle. The overall results suggest a change in the neuromuscular strategy of the main extensor muscles of the lower limb of diabetic patients to compensate the ankle extensor deficit to propel the body forward and accomplish the walking task.
authors.affiliation: University of São Paulo, School of Medicine, Physical Therapy, Speech and Occupational Therapy Department, Brazil. Electronic address: icnsacco@usp.br.
authors.forename: I C N
authors.initials: IC
authors.lastname: Sacco
authors.affiliation: University of São Paulo, School of Medicine, Physical Therapy, Speech and Occupational Therapy Department, Brazil.
authors.forename: A N
authors.initials: AN
authors.lastname: Hamamoto
authors.affiliation: University of São Paulo, School of Medicine, Physical Therapy, Speech and Occupational Therapy Department, Brazil.
authors.forename: A N
authors.initials: AN
authors.lastname: Onodera
authors.affiliation: Federal University of Amazonas, School of Physical Education and Physiotherapy, Brazil.
authors.forename: A A
authors.initials: AA
authors.lastname: Gomes
authors.affiliation: Santo André Foundation, São Paulo, Brazil.
authors.forename: H A
authors.initials: HA
authors.lastname: Weiderpass
authors.affiliation: University of São Paulo, School of Medicine, Medical Informatics Department, Brazil.
authors.forename: C G F
authors.initials: CG
authors.lastname: Pachi
authors.affiliation: University of São Paulo, Hospital das Clínicas, Brazil.
authors.forename: J F
authors.initials: JF
authors.lastname: Yamamoto
authors.affiliation: Human Performance Laboratory, Faculty of Kinesiology, The University of Calgary, Calgary, Alberta, Canada.
authors.forename: V
authors.initials: V
authors.lastname: von Tscharner
mesh_terms: D000843:Ankle Joint / Q000502:physiology; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000503:physiopathology*; D004576:Electromyography; D005260:Female; D005528:Foot / Q000502:physiology; D005684:Gait / Q000502:physiology*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D052097:Quadriceps Muscle / Q000503:physiopathology*; D012815:Signal Processing, Computer-Assisted; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology; D058067:Wavelet Analysis
keywords: Diabetic polineuropathies; Electromyography; Gait; Neuromuscular strategy; Wavelet analysis