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关节活动受限和平衡控制对糖尿病周围神经病变患者步态改变的影响

Effect of joint limitation and balance control on gait changes in diabetic peripheral neuropathy.

作者信息

Yamasaki Hiroyuki, Abe Yoshiro, Mima Shunsuke, Bando Mayu, Nagasaka Shinji, Yamashita Yutaro, Mineda Kazuhide, Kuroda Akio, Matsuhisa Munehide, Takaiwa Masahiro, Hashimoto Ichiro

机构信息

Department of Plastic and Reconstructive Surgery, Tokushima University Graduate School of Medical Science, 3-Chome Kuramoto, Tokushima, Japan.

Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan.

出版信息

Diabetol Int. 2023 Jul 24;14(4):390-396. doi: 10.1007/s13340-023-00647-9. eCollection 2023 Oct.

Abstract

AIMS

This study analyzed the gait patterns of diabetic peripheral neuropathy (DPN) patients and changes in the center of mass sway to prevent the formation and recurrence of foot ulcers.

METHODS

Forty-two subjects were divided into the diabetes mellitus (DM), DPN, and diabetic foot ulcer (DFU) groups. We measured the range of motion (ROM) of the lower limb joints in the resting position and the center of mass sway in the standing position. Joint angles, ROM during walking, and distance factors were evaluated.

RESULTS

In the DFU group, ROM limitation during walking was detected at the knee joint, and functional and ROM limitations were found at the ankle joint. The step length ratio and step width in the DFU group were significantly lower and higher than those in the DM group, respectively. The sway distances in the DFU group were greater than those in the DM and DPN groups.

CONCLUSIONS

Functional joint limitations and gait changes due to the decreased ability to maintain the center of gravity were observed in the DFU group. As DPN progressed, the patients' gait became small, wide, and shuffled. Thus, supporting joint movement during walking may help reduce the incidence and recurrence of foot ulcers.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13340-023-00647-9.

摘要

目的

本研究分析糖尿病周围神经病变(DPN)患者的步态模式以及重心摆动变化,以预防足部溃疡的形成和复发。

方法

42名受试者被分为糖尿病(DM)组、DPN组和糖尿病足溃疡(DFU)组。我们测量了下肢关节在休息位的活动范围(ROM)以及站立位的重心摆动。评估了关节角度、步行时的ROM和距离因素。

结果

在DFU组中,步行时膝关节存在ROM受限,踝关节存在功能和ROM受限。DFU组的步长比和步宽分别显著低于和高于DM组。DFU组的摆动距离大于DM组和DPN组。

结论

在DFU组中观察到由于维持重心能力下降导致的关节功能受限和步态变化。随着DPN的进展,患者的步态变小、变宽且拖沓。因此,步行时支持关节活动可能有助于降低足部溃疡的发生率和复发率。

补充信息

在线版本包含可在10.1007/s13340-023-00647-9获取的补充材料。

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