Article

The World Health Organization warns that, in 2000, as many as 33 million
Europeans suffered from diabetes, approximately 15% will likely develop foot
ulcers, and approximately 15-20% of these patients will face lower-extremity
amputation. Changes in some gait parameters that appear to be specific in
diabetes have been identified in the literature: shorter stride length, reduced
walking speed, and altered lower limb and trunk mobility.
The present study aimed
at evaluating the role of altered muscle activity in gait alterations of diabetic
subjects with and without neuropathy. This study involved 50 subjects: 10
controls (BMI 24.4 +/- 2.8, age 61.2 +/- 5.07), 20 diabetics (BMI 26.4 +/- 2.5,
age 56.53 +/- 13.29) and 20 neuropathics (BMI 26.8 +/- 3.4, age 61.2 +/- 7.7).
The electrical activity of six muscles was collected bilaterally on the lower
limb during gait: gluteus medius, rectus femoris, tibialis anterior, peroneous
longus, gastrocnemius lateralis, and extensor digitorum communis.
Electromyographic activity was represented through linear envelopes. Time and
space parameters were also evaluated by means of two Bertec force plates and a
six cameras motion capture system (BTS, 60-120 Hz).
At initial contact and
loading response, an early peak of rectus femoris activity occurred in diabetic
subjects with and without neuropathy. During midstance a delay of gastrocnemius
activity was observed in diabetic non-neuropathic subjects. During terminal swing
a delay of rectus femoris and gluteus medius activity was seen in diabetic
non-neuropathic subjects'. The results suggest that important muscle activity
deviations are present in diabetic subjects although these are not directly related to neuropathy.
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