Electromyography and kinematic changes of gait cycle at different cadences in diabetic neuropathic individuals

TLDR: These findings suggest that when diabetic individuals face a new challenging situation that induces a higher demand for muscle strength and propulsion, the necessary range of motion and neuromuscular control around distal joints are insufficient.

Abstract: Introduction: Changes in gait cadence caused by challenging situations in daily life might induce higher demand for strength and propulsion in diabetic neuropathic (DN) sub- jects. Methods: Forty-six subjects (healthy and DN) walked at two cadences (self-selected and 25% higher). Kinematic and electromyographic data were obtained from lower limbs and compared across the gait cycle. Results: DN subjects showed a delayed peak in plantarflexor activity along the whole cycle (irre- spective of cadence) compared with healthy subjects. However, during the imposed cadence, DN individuals showed reduced ankle range of motion along the entire cycle compared with the self-selected condition and healthy individuals walking at both cadences (P ¼ 0.002). Conclusions: These findings suggest that when diabetic individuals face a new challenging situation that induces a higher demand for muscle strength and propul- sion, the necessary range of motion and neuromuscular control around distal joints are insufficient. Muscle Nerve 44: 258-268, 2011 The biomechanical pattern of gait is highly repeti- tive, cyclic, and has low variation across steps as well as across days. 1 This feature allows us to use gait analysis as an experimental model to investi- gate the influence of the environment, such as real-life challenges and perturbations, and biology, such as neuromuscular diseases. These two factors might impair both the coordinated harmonic action of the lower limbs and the neuromuscular strategies adopted for the control of locomotion. Diabetic neuropathy (DN) impairs both the soma- tosensory and motor control systems, 2,3 and affects the amount and quality of the sensory information that is essential for the complexity involved in gait generation and control. 4 The regularity of normal gait allows for the establishment of basic biome- chanical criteria to distinguish between normal and pathologic patterns of movement, such as gait patterns in DN individuals.