Article

Gait characteristics and balance are altered in diabetic individuals.
Little is known about possible treatment strategies. This study evaluated the
effect of a specific training program on diabetic patients' gait. METHODS: A
randomized controlled trial (N=71) with an intervention (IG) (N=35), and control
group (CG) (N=36). The intervention consisted of physiotherapeutic group training
including gait and balance exercises with function-oriented strengthening.
Controls received no treatment. RESULTS: After intervention the IG increased
their habitual walking speed by 0.149ms(-1) (0.54kmh(-1)) on tarred terrain and
by 0.169ms(-1) (0.61kmh(-1)) on the cobblestones. This significant treatment
effect (p<0.001) decreased slightly at the six-month follow-up, but remained
significant (p<0.001). In a similar manner, significant improvement was observed
for cadence, gait cycle time and stance time on both terrains. All outcomes
except stance time on the tarred terrain remained significant at the six-month
follow-up. No significant effect was observed for stride length and the
coefficient of variation of gait cycle time (on either surface) at the corrected
significance level of p<0.004. CG patients' parameters all remained unchanged or
progressively deteriorated compared to baseline values. DISCUSSION: Cadence
contributed 80%, whereas stride length only contributed 20% to the change of gait
velocity. This may be due to the treatment or to diabetic patients' potential to
regulate their cadence and stride length. CONCLUSION: A specific training program
can improve diabetic patients' gait in a real life environment. A challenging
environment highlights treatment effects on patients' gait better than an evenly
tarred surface.
CI - Copyright 2010 Elsevier B.V. All rights reserved.

Langue : ANGLAIS