title: Investigating the role of neuropathic pain relief in decreasing gait variability in diabetes mellitus patients with neuropathic pain: a randomized, double-blind crossover trial.
abstract: BACKGROUND
  Subjects with diabetes mellitus (DM) develop gait dysfunction contributing to falls, reluctance to perform activities and injuries. Neuropathic pain (NeP) related to diabetic peripheral neuropathy (DPN) is associated with increased gait variability that may contribute to gait dysfunction. We used a portable device (GaitMeter™) and related gait and balance measures to measure gait parameters in painful DPN (PDPN) subjects prior to and during analgesia. Our hypothesis was that PDPN subjects would have decreased gait step variability when receiving pharmacological relief of NeP.
  
  
  METHODS
  DPN subjects with at least moderate NeP were assessed in a randomized, double-blind crossover study of pregabalin versus placebo. The outcome measure was variability in step length and step velocity. Testing for Timed Get-Up-and-Go Test, Tinetti Mobility Scales, Sway Testing, a Physiological Profile Approach, and fall-related surveys were also performed. DPN severity was quantified using the Utah Early Neuropathy Score.
  
  
  RESULTS
  PDPN subjects developed increased, rather than decreased, step length and step velocity variability during pregabalin treatment. There were no significant differences between cohorts for other physiological gait and balance testing. Non-significant NeP relief occurred in the pregabalin phase of study as compared with placebo. There was a negative relationship for step length with pain severity.
  
  
  CONCLUSIONS
  Analgesia did not decrease gait variability in PDPN patients, and in fact, increased gait variability was seen during pregabalin treatment. Other important relationships of gait dysfunction with PDPN should be sought.
authors.forename: Surshen
authors.initials: S
authors.lastname: Karmakar
authors.forename: Houman
authors.initials: H
authors.lastname: Rashidian
authors.forename: Cynthia
authors.initials: C
authors.lastname: Chan
authors.forename: CaiXia
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Clinical Neurosciences, HMRB 155, Foothills Hospital, University of Calgary, Hotchkiss Brain Institute, 3330 Hospital Dr, NW, Calgary T2N 4 N1, AB, Canada. corytoth@shaw.ca.
authors.forename: Cory
authors.initials: C
authors.lastname: Toth
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003929:Diabetic Neuropathies / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005684:Gait / Q000187:drug effects*; D020233:Gait Disorders, Neurologic / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid