The effect of exercise on the gait biomechanics of the neuro-ischemic diabetic foot with peripheral neuropathy

Abstract

The aim of the study was to investigate the effect of a six-week exercise program on the kinetics and kinematics during gait in people diagnosed with ischemia and diabetic peripheral neuropathy. The peak plantar pressures, pressure-time integral, lower limb joint angles in the sagittal plane and ground reaction forces were tested before and after the exercise program. Research in this area is lacking, providing only small scale studies with mixed results and decreased significance. The researcher aimed to add to the body of knowledge and provide further insight into the possible use of exercise to prevent and manage the complications of diabetic peripheral neuropathy such as the development of pressure ulcers. Methodology: Twelve participants were chosen for this pilot study, and were asked to carry out a specialised exercise program for six weeks, twice weekly. The kinematics and ground reaction forces were tested using 3D motion analysis (Vicon) and force plates (AMTI) and plantar pressures and pressure-time integral were tested via the TekScan HR mat. The patients acted as their own control, comparing pre- and post- intervention results. Results showed a statistically significant decrease in plantar pressures in all areas and in the pressuretime integral at the forefoot. Hip flexion at toe-off and knee extension at heel strike showed a statistically significant improvement. All other areas showed a slight improvement but were not statistically significant, thus failing to reject the null hypothesis. Conclusion: Although improvements were seen, this pilot study requires further research to support the findings in this study and possibly implement these findings in clinical practice in the future.