Characteristics of functional gait among people with and without peripheral neur

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Gait Posture. 2009 May 25.

Characteristics of functional gait among people with and without peripheral

neuropathy.

Manor B, Li L.

Department of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical

School, United States.

It is advantageous from a rehabilitation standpoint to determine physiological

factors associated with functional gait. These factors may be fundamentally

different in those with peripheral neuropathy (PN) compared to age-matched

healthy individuals. The purpose of this investigation was to examine

associations between functional gait and measures of leg strength, standing

balance, and locomotor kinematics in people with and without PN.

METHODS: Individuals with PN and age-matched controls were assessed for

functional gait by the 6-min walk and timed up-and-go tests. Leg strength was

measured as isokinetic peak torque of the knee extensors. Standing balance was

assessed by center-of-pressure sway velocity and area during quiet stance.

Locomotor kinematics from treadmill walking were used to compute stride duration

variability and local instability (i.e., finite-time Lyapunov exponents), which

estimate kinematic divergence caused by small-scale perturbations.

RESULTS: Leg strength and locomotor kinematics - in particular local instability

- correlated with functional gait performance in controls. Conversely, reduced

functional gait performance in the PN group was primarily mediated by impaired

standing balance control. DISCUSSION: Locomotor kinematics predicts functional

gait, and the magnitude of variability and local instability should be

calculated to fully evaluate locomotor system health. The observation that

different factors associated with functional gait between groups speaks to the

uniqueness of the PN-related movement disorder. Functional gait-related

rehabilitation programs for PN patients should be tailored toward this

uniqueness.