Gait termination in the young, the healthy elderly, and the elderly with type 2 diabetes affected by peripheral neuropathy

Abstract

Terminating gait puts special demands on the body as a transition occurs from a dynamic to a quasi-static situation. Elderly people can have difficulties in stopping due to age related physiological decline. It is unknown if these difficulties worsen for elderly people with impaired foot sensitivity such as those with diabetes. The study analysed biomechanical characteristics of gait termination in healthy young (Young), healthy elderly (Elderly) persons, and elderly people with type 2 diabetes (Diabetics) affected by peripheral neuropathy. The measured variables related to gait termination are the vibration, sensitivity threshold, the A/P (anterior/posterior) COM (Centre of mass) velocities at specific events, the COP (Centre of pressure) and COM overshoots in the A/P and M/L (medio/lateral) directions and force related variables (among others: maximal forces, relative time needed to develop these forces, and impulses). Statistical differences in the vibration sensitivity threshold were found between all three groups. The difference between the Young and the Elderly is smallest, whereas the differences between the Elderly and the Diabetics and between the Diabetics and the Young are the same. The results demonstrate that under the tested conditions, the COP and COM overshoots do not differ between the Elderly and the Diabetics. However, the Diabetics always exhibited the weakest maximal forces of the three groups. In addition, Diabetics took the longest relative time to develop these forces compared with the Young and the Elderly. These results indirectly confirm the increased reaction time present in elderly people affected with diabetes and peripheral neuropathy. During the Approach Phase, the Diabetics developed the highest propulsion impulse. During the Stopping Phase, however, their braking impulses were the weakest. To confirm these results, further studies controlling the COM velocities prior to gait termination and/or demanding more specific tasks will have to be performed."--Résumé abrégé par UMI