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Gait stability of diabetic patients is altered with the rigid rocker shoes

Ghomian, Banafshe; Naemi, Roozbeh; Mehdizadeh, Sina; Jafari, Hassan; Ebrahimi Takamjani, Ismael; Aghili, Rokhsareh; Mendes Machado, José; Fernando Sousa Ferreira Silva, Luís; Saeedi, Hassan

Authors

Banafshe Ghomian

Sina Mehdizadeh

Hassan Jafari

Ismael Ebrahimi Takamjani

Rokhsareh Aghili

José Mendes Machado

Luís Fernando Sousa Ferreira Silva

Hassan Saeedi



Abstract

Background
Rigid-rocker shoes may induce gait instability in diabetics, however, this is not clearly investigated. The present study investigates if rigid-rocker shoes influence diabetic gait stability.
Methods
Fourteen non-neuropathic and nine neuropathic diabetics, plus eleven healthy young-adults were recruited. Full-body kinematic data was captured during walking. Experimental conditions included barefoot and three rocker-shoe designs according to the rocker angle, apex angle and apex position (R10: 10°, 80°, 60%; R15: 15°, 95°, 52%; R20: 20°, 95°, 60%). Sagittal and frontal stability margin, plus fear of fall were main outcome measures.
Findings.
Sagittal stability margin was not affected by health, however, was increased with R10 and R15 in non-neuropathic diabetics and healthy individuals (R2 = 0.16). Variability of sagittal stability margin was not altered in neuropathic diabetics, but was increased with R15 and R20 in healthy participants, with R15 in non-neuropathic diabetics (R2 = 0.12). Frontal stability margin (R2 = 0.46) and its variability (R2 = 0.39) were significantly increased in neuropathic and non-neuropathic diabetics compared to healthy individuals. Frontal stability margin was significantly higher with R15 in neuropathic diabetics, and with R20 in both non-neuropathic and healthy participants. Sagittal and frontal stability margin were strongly correlated with fear of fall in neuropathic diabetics.
Interpretations.
R15 and R20 might challenge gait stability of diabetics cause them restrict centre of mass motion thereby imposing a tighter control over walking. However, neuropathic diabetics generally walk very cautious due to neuropathy and increased fear of fall. Frontal stability margin, highly affected by health and experimental condition, is a more sensitive indicator of gait stability.

Citation

Ghomian, B., Naemi, R., Mehdizadeh, S., Jafari, H., Ebrahimi Takamjani, I., Aghili, R., …Saeedi, H. (2019). Gait stability of diabetic patients is altered with the rigid rocker shoes. Clinical Biomechanics, 69, 197-204. https://doi.org/10.1016/j.clinbiomech.2019.06.015

Journal Article Type Article
Online Publication Date Jun 24, 2019
Publication Date 2019-10
Deposit Date Apr 14, 2024
Journal Clinical Biomechanics
Print ISSN 0268-0033
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 69
Pages 197-204
DOI https://doi.org/10.1016/j.clinbiomech.2019.06.015