Article

People with type II diabetes mellitus (DM) are at a high risk of falling
especially during more challenging locomotor tasks such as obstacle-crossing. The
current study aimed to identify the risk factors for tripping in these patients
during trailing-limb obstacle-crossing. Fourteen patients with type II DM with or
without mild peripheral neuropathy (PN) and 14 healthy controls walked and
crossed obstacles of three different heights while their motion data were
measured using a motion capture system and two forceplates. The DM group was
found to cross obstacles with significantly reduced trailing toe clearance
(p<0.05), increasing the probability of the foot hitting the obstacle, and thus
the risk of tripping. This altered end-point control was associated with
significantly reduced knee flexion and hip adduction of the trailing swing limb
(p<0.05), as well as significantly increased ankle plantarflexor moments in the
leading stance limb (p<0.05). Therefore, reduced knee flexion and hip adduction
of the swing limb are identified as risk factors for tripping during
obstacle-crossing. Increased mechanical demands on the ankle plantarflexors
suggest that weakness of these muscles may further reduce the already compromised
performance of obstacle-crossing in these patients. The current results showed
that obstacle-crossing can be used to detect gait deviations and to identify the
associated risk of tripping in patients with type II DM without or at an early
stage of PN.
CI - Copyright (c) 2016 Elsevier B.V. All rights reserved.

Langue : ANGLAIS