Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/17700
Appears in Collections:Psychology Journal Articles
Peer Review Status: Refereed
Title: Biomechanical characteristics of peripheral diabetic neuropathy: A systematic review and meta-analysis of findings from the gait cycle, muscle activity and dynamic barefoot plantar pressure
Author(s): Fernando, Malindu
Crowther, Robert
Lazzarini, Peter
Sangla, Kunwarjit
Cunningham, Margaret
Buttner, Petra
Golledge, Jonathan
Contact Email: mc52@stir.ac.uk
Keywords: Biomechanics
Diabetes complications
Diabetes mellitus
Diabetic foot
Diabetic peripheral neuropathy
Electromyography
Gait
Meta-analysis
Movement analysis
Plantar pressure
Systematic review
Type 1 diabetes
Type 2 diabetes
Issue Date: Oct-2013
Date Deposited: 8-Nov-2013
Citation: Fernando M, Crowther R, Lazzarini P, Sangla K, Cunningham M, Buttner P & Golledge J (2013) Biomechanical characteristics of peripheral diabetic neuropathy: A systematic review and meta-analysis of findings from the gait cycle, muscle activity and dynamic barefoot plantar pressure. Clinical Biomechanics, 28 (8), pp. 831-845. https://doi.org/10.1016/j.clinbiomech.2013.08.004
Abstract: BACKGROUND Diabetic peripheral neuropathy is an important cause of foot ulceration and limb loss. This systematic review and meta-analysis investigated the effect of diabetic peripheral neuropathy on gait, dynamic electromyography and dynamic plantar pressures. METHODS Electronic databases were searched systematically for articles reporting the effect of diabetic peripheral neuropathy on gait, dynamic electromyography and plantar pressures. Searches were restricted to articles published between January 2000 and April 2012. Outcome measures assessed included spatiotemporal parameters, lower limb kinematics, kinetics, muscle activation and plantar pressure. Meta-analyses were carried out on all outcome measures reported by ≥3 studies. FINDINGS Sixteen studies were included consisting of 382 neuropathy participants, 216 diabetes controls without neuropathy and 207 healthy controls. Meta-analysis was performed on 11 gait variables. A high level of heterogeneity was noted between studies. Meta-analysis results suggested a longer stance time and moderately higher plantar pressures in diabetic peripheral neuropathy patients at the rearfoot, midfoot and forefoot compared to controls. Systematic review of studies suggested potential differences in the biomechanical characteristics (kinematics, kinetics, EMG) of diabetic neuropathy patients. However these findings were inconsistent and limited by small sample sizes. INTERPRETATION Current evidence suggests that patients with diabetic peripheral neuropathy have elevated plantar pressures and occupy a longer duration of time in the stance-phase during gait. Firm conclusions are hampered by the heterogeneity and small sample sizes of available studies.
DOI Link: 10.1016/j.clinbiomech.2013.08.004
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