Department of Clinical Neurosciences, the Hotchkiss Brain Institute and the University of Calgary, Calgary, AB, Canada.
J Diabetes Complications. 2013 May-Jun;27(3):248-54. doi: 10.1016/j.jdiacomp.2012.10.013. Epub 2012 Dec 4.
Gait dysfunction in subjects with diabetes mellitus (DM) contributes to falling and subsequent injuries. Using a portable device (GaitMeter™), we measured gait parameters in DM patients with and without diabetic peripheral neuropathy (DPN) during flat surface walking. We hypothesized that DM patients with DPN and neuropathic pain (NeP) would have greater gait step variability than those with DPN without NeP.
Subjects with DPN and at least moderate NeP (DPN-P), DPN without NeP (DPN-NoP), DM without DPN, and control subjects without DM were assessed. Our outcome measure was gait variability for step length and velocity. DPN severity was quantified using the Toronto Clinical Scoring System and the Utah Early Neuropathy Score. Falls and their outcomes were retrospectively quantified.
Each cohort contained≥20 subjects. Durations of DM and HbA1C were greatest amongst DPN cohorts. DPN-P participants had greater variability of step length and step velocity, except for DM only participants. DPN-P participants also reported greater risk of hospitalizations for fall-related injuries, and greater fear of falling. Modest negative relationships emerged for step length with step velocity, reported falls and pain severity.
NeP contributes to gait variability, potentially contributing to the risk of falling in DM patients.
糖尿病患者（DM）的步态功能障碍会导致跌倒和随后的损伤。我们使用便携式设备（步态计）测量了伴有和不伴有糖尿病周围神经病变（DPN）的 DM 患者在平坦表面行走时的步态参数。我们假设伴有神经病变性疼痛（NeP）的 DPN 患者的步态步长变异性会大于不伴有 NeP 的 DPN 患者。
评估了伴有 DPN 和至少中度 NeP（DPN-P）、不伴有 NeP 的 DPN（DPN-NoP）、无 DPN 的 DM 和无 DM 的对照组患者。我们的观察指标是步长和速度的步态变异性。多伦多临床评分系统和犹他州早期神经病变评分用于量化 DPN 的严重程度。回顾性量化跌倒及其结果。
每个队列都包含≥20 名患者。DM 和 HbA1C 的持续时间在 DPN 队列中最长。除了仅 DM 患者外，DPN-P 患者的步长和步速变异性更大。DPN-P 患者还报告了因跌倒相关伤害而住院的风险更高，以及对跌倒的恐惧更大。步长与步速、报告的跌倒和疼痛严重程度之间出现了适度的负相关关系。
神经病变导致步态变异性，可能导致 DM 患者跌倒的风险增加。
