A comparison of gait characteristics between older women with and without peripheral neuropathy in standard and challenging environments.

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Abstract from J Am Geriatr Soc. 2004 Sep;52(9):1532-7.

A comparison of gait characteristics between older women with and

without peripheral neuropathy in standard and challenging environments.

JK, Thies SB, DeMott TK, Ashton- JA.

Departments of Physical Medicine and Rehabilitation and Mechanical

Engineering, University of Michigan, Ann Arbor, Michigan.

Objectives:

To compare gait patterns in older women with and without peripheral

neuropathy (PN) in standard (smooth surface, normal lighting) and

challenging environments (CE) (irregular surface, low lighting).

Design:

Observational, controlled study of 24 subjects.

Setting:

Biomechanical research laboratory.

Participants:

Twenty-four older women, 12 with PN and 12 without PN (mean

age+/-standard deviation =67.1+/-7.9 and 70.2+/-4.3, respectively).

Measurements:

Gait parameters and, in the 12 PN subjects, neuropathy severity.

Results: The CE was associated with increases in step width, step-width

variability, step-width range, step width-to-step length ratio, step

time and step-time variability, and decreases in step length and speed.

The PN subjects demonstrated a greater step width-to-step length ratio

and step time and shorter step length and slower speed than the control

subjects. In adapting to the CE, the PN subjects demonstrated greater

increases in step width-to-step length ratio and step-time variability

and a greater decrease in step length than did the control subjects. In

the standard environment, only one gait parameter correlated with PN

severity, whereas in the CE, four gait parameters did so.

Conclusion: The subjects demonstrated a gait that was slower, less

efficient, and more variable temporally and in the frontal plane in the

CE. Control and PN subjects demonstrated similar variability in

medial-lateral step placement in the CE but at the cost of speed and

efficiency for the PN subjects. Because the CE magnified gait

differences between the two groups of subjects and caused gait changes

in the PN subjects that correlated with PN severity, the CE may offer

improved resolution for detecting gait abnormalities.