Nursing Department, Faculty of Nursing and Podiatry, University of Valencia, Valencia, Spain.
Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy.
Int Wound J. 2023 Oct;20(8):3023-3034. doi: 10.1111/iwj.14178. Epub 2023 Apr 14.
Peripheral neuropathy is a prevalent complication of diabetes that can lead to gait impairment and its adverse consequences. This study explored the potential utility of different parameters of gait analysis using a single sensor unit as a simple tool to detect peripheral neuropathy in 85 diabetic patients (DP) with diabetic foot in whom different somato-sensitivity tests in the feet were performed. Gait spatiotemporal parameters were examined by sensor inertial measurement placed in the lumbar area, while the superficial sensitivity pathway was assessed by nociception tests and deep sensitivity was examined by light touch-pressure and vibration sensitivity tests. Correlations between each sensory test and gait parameters were analysed in a logistic regression model in order to assess if gait parameters are associated with two different sensory pathways. Impaired deep sensory pathways were significantly (P < .05) correlated with lower gait speed, reduced cadence, smaller stride length, longer stance periods, and a higher risk of falling on the Tinetti Scale, while all gait parameters were significantly (P < .01) correlated with the superficial sensory pathway. Type 2 diabetics have significantly (P < .05) higher impairment in vibratory sensitivity than type 1 diabetics, and the years with diabetes mellitus (DM) diagnosis have a significant (P < .05) association with reduced vibration sensitivity. These findings indicate relationships between the deep sensory pathway and gait impairments in DP measured by inertial sensors, which could be a useful tool to diagnose gait alterations in DP and to evaluate the effect of treatments to improve gait and thus the risk of falls in diabetic patients.
周围神经病变是糖尿病的一种常见并发症,可导致步态障碍及其不良后果。本研究探讨了使用单个传感器单元分析不同步态参数的潜在效用,作为一种简单的工具,以检测 85 例患有糖尿病足的糖尿病患者(DP)中的周围神经病变,这些患者的足部进行了不同的体感觉测试。通过放置在腰部的传感器惯性测量来检查步态时空参数,而通过伤害感受测试评估浅表感觉通路,通过轻触压和振动感觉测试评估深部感觉。通过逻辑回归模型分析每个感觉测试与步态参数之间的相关性,以评估步态参数是否与两种不同的感觉通路相关。深部感觉通路受损与较低的步态速度、降低的步频、较小的步长、较长的站立期以及在 Tinetti 量表上更高的跌倒风险显著相关(P < .05),而所有步态参数与浅表感觉通路显著相关(P < .01)。2 型糖尿病患者的振动感觉敏感性明显(P < .05)比 1 型糖尿病患者高,糖尿病诊断年限与振动感觉敏感性降低有显著(P < .05)的关联。这些发现表明,惯性传感器测量的 DP 深部感觉通路与步态障碍之间存在关系,这可能是一种有用的工具,用于诊断 DP 中的步态改变,并评估治疗效果以改善步态,从而降低糖尿病患者的跌倒风险。