Clinical factors associated with a conservative gait pattern in older male veterans with diabetes

<p>Abstract</p> <p>Background</p> <p>Patients with diabetes and peripheral neuropathy are at higher risk for falls. People with diabetes sometimes adopt a more conservative gait pattern with decreased walking speed, widened base, and increased double support time. The p...

Full description

Bibliographic Details
Main Authors: Crews Ryan T, Wrobel James S, Connolly John E
Format: Article
Language:English
Published: Wiley 2009-04-01
Series:Journal of Foot and Ankle Research
Online Access:http://www.jfootankleres.com/content/2/1/11
_version_ 1797225242315194368
author Crews Ryan T
Wrobel James S
Connolly John E
author_facet Crews Ryan T
Wrobel James S
Connolly John E
author_sort Crews Ryan T
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Patients with diabetes and peripheral neuropathy are at higher risk for falls. People with diabetes sometimes adopt a more conservative gait pattern with decreased walking speed, widened base, and increased double support time. The purpose of this study was to use a multivariate approach to describe this conservative gait pattern.</p> <p>Methods</p> <p>Male veterans (mean age = 67 years; SD = 9.8; range 37–86) with diabetes (n = 152) participated in this study from July 2000 to May 2001 at the Veterans Affairs Medical Center, White River Junction, VT. Various demographic, clinical, static mobility, and plantar pressure measures were collected. Conservative gait pattern was defined by visual gait analysis as failure to demonstrate a heel-to-toe gait during the propulsive phase of gait.</p> <p>Results</p> <p>Patients with the conservative gait pattern had lower walking speed and decreased stride length compared to normal gait. (0.68 m/s v. 0.91 m/s, <it>p </it>< 0.001; 1.04 m v. 1.24 m, <it>p </it>< 0.001) Age, monofilament insensitivity, and Romberg's sign were significantly higher; and ankle dorsiflexion was significantly lower in the conservative gait pattern group. In the multivariate analysis, walking speed, age, ankle dorsiflexion, and callus were retained in the final model describing 36% of the variance. With the inclusion of ankle dorsiflexion in the model, monofilament insensitivity was no longer an independent predictor.</p> <p>Conclusion</p> <p>Our multivariate investigation of conservative gait in diabetes patients suggests that walking speed, advanced age, limited ankle dorsiflexion, and callus describe this condition more so than clinical measures of neuropathy.</p>
first_indexed 2024-03-08T07:09:08Z
format Article
id doaj.art-deea45b0347c4f388b8f184547b97ca1
institution Directory Open Access Journal
issn 1757-1146
language English
last_indexed 2024-04-24T14:05:54Z
publishDate 2009-04-01
publisher Wiley
record_format Article
series Journal of Foot and Ankle Research
spelling doaj.art-deea45b0347c4f388b8f184547b97ca12024-04-03T10:36:06ZengWileyJournal of Foot and Ankle Research1757-11462009-04-01211110.1186/1757-1146-2-11Clinical factors associated with a conservative gait pattern in older male veterans with diabetesCrews Ryan TWrobel James SConnolly John E<p>Abstract</p> <p>Background</p> <p>Patients with diabetes and peripheral neuropathy are at higher risk for falls. People with diabetes sometimes adopt a more conservative gait pattern with decreased walking speed, widened base, and increased double support time. The purpose of this study was to use a multivariate approach to describe this conservative gait pattern.</p> <p>Methods</p> <p>Male veterans (mean age = 67 years; SD = 9.8; range 37–86) with diabetes (n = 152) participated in this study from July 2000 to May 2001 at the Veterans Affairs Medical Center, White River Junction, VT. Various demographic, clinical, static mobility, and plantar pressure measures were collected. Conservative gait pattern was defined by visual gait analysis as failure to demonstrate a heel-to-toe gait during the propulsive phase of gait.</p> <p>Results</p> <p>Patients with the conservative gait pattern had lower walking speed and decreased stride length compared to normal gait. (0.68 m/s v. 0.91 m/s, <it>p </it>< 0.001; 1.04 m v. 1.24 m, <it>p </it>< 0.001) Age, monofilament insensitivity, and Romberg's sign were significantly higher; and ankle dorsiflexion was significantly lower in the conservative gait pattern group. In the multivariate analysis, walking speed, age, ankle dorsiflexion, and callus were retained in the final model describing 36% of the variance. With the inclusion of ankle dorsiflexion in the model, monofilament insensitivity was no longer an independent predictor.</p> <p>Conclusion</p> <p>Our multivariate investigation of conservative gait in diabetes patients suggests that walking speed, advanced age, limited ankle dorsiflexion, and callus describe this condition more so than clinical measures of neuropathy.</p>http://www.jfootankleres.com/content/2/1/11
spellingShingle Crews Ryan T
Wrobel James S
Connolly John E
Clinical factors associated with a conservative gait pattern in older male veterans with diabetes
Journal of Foot and Ankle Research
title Clinical factors associated with a conservative gait pattern in older male veterans with diabetes
title_full Clinical factors associated with a conservative gait pattern in older male veterans with diabetes
title_fullStr Clinical factors associated with a conservative gait pattern in older male veterans with diabetes
title_full_unstemmed Clinical factors associated with a conservative gait pattern in older male veterans with diabetes
title_short Clinical factors associated with a conservative gait pattern in older male veterans with diabetes
title_sort clinical factors associated with a conservative gait pattern in older male veterans with diabetes
url http://www.jfootankleres.com/content/2/1/11
work_keys_str_mv AT crewsryant clinicalfactorsassociatedwithaconservativegaitpatterninoldermaleveteranswithdiabetes
AT wrobeljamess clinicalfactorsassociatedwithaconservativegaitpatterninoldermaleveteranswithdiabetes
AT connollyjohne clinicalfactorsassociatedwithaconservativegaitpatterninoldermaleveteranswithdiabetes