Alterations in lower extremity muscular activation and joint angle patterns during gait in patients with type-2 diabetes mellitus with and without polyneuropathy

Abstract

Aim: The aim of this study was to determine Type 2 Diabetes Mellitus (DM) and DiabeticPolyneuropathy (DPN) related lower extremity muscle activation and joint angle alterationsindependently from the gait speed.Material and Methods: 10 Type 2 DM, 8 DPN and 10 healthy age-matched subjects wereevaluated at a comfortable and a test speed of 1.4 m/s. Gait characteristics, muscularactivation characteristics and joint angle characteristics for the ankle, knee and hip joints weredetermined.Results: It has been determined that gait speed is lower (p=0.374) and relative duration ofstance phase is higher (p=0.433) in DPN group subjects. It has been found out that m. tibialisanterior off time is delayed (p=0.022), m.vastus medialis activation amplitude is lower(p=0.045), activation duration is longer (p=0.028) in DPN group subjects at test gait speed.Knee joint range of motion (p=0.048) and maximum knee joint extension angle is smaller(p=0.076) in DM and DPN group subjects.Conclusion: Our study has shown that when the gait speed has been standardized, lowerextremity muscular activation changes at the ankle and knee joint levels in DPN, and the jointangle differences at the knee joint level in relation to DM and DPN emerge during the earlyperiod of the stance phase. It is obvious that these changes will cause some impairments inbraking force capacity while transfering the body weight from the heel to the forefootgradually during gait.