Article

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.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS