The Influence of Peripheral Neuropathy on Walking Kinematics and Physical Function
The 108th Congress (2005) has reported that 20 million U.S. citizens suffer from Peripheral Neuropathy (PN). Characterized by sensory nerve deterioration, PN reduces somatosensation (Padua et al., 2005) and increases the risk of fall-related injury (Richardson et al., 1992). The purpose of this dissertation was to provide insight into 1) the effects of acute loss of foot sole sensation on locomotor system health, 2) the effects of PN on locomotor system health, and 3) the underlying impairments associated with reduced physical function within the older adult and PN populations.
Locomotor system health was assessed by the magnitude of stride-to-stride variability and local instability contained in the kinematics of treadmill walking. In healthy young adults, ice-induced reduction of foot sole sensation did not alter the magnitude of stride-to-stride variability during treadmill walking. It did, however, increase lower-extremity joint local instability, or the sensitivity to small scale perturbations. Compared to controls, individuals with PN walked with similar local instability yet increased variability, at relatively slow speeds. When walking at relatively fast speeds, individuals with PN exhibited exaggerated increases in local instability.
In healthy older adults, locomotion-based physical function (LBPF), as defined by 6-minute walk and Timed Up-and-Go performance, was correlated to leg strength and measures of locomotor system health. However, only measures of locomotor system health provided independent predictive information of LBPF. The PN group exhibited reduced LBPF. As opposed to healthy old adults, correlates of LBPF were not leg strength but instead standing balance variables. Multiple variables of leg strength, standing balance, and locomotor system health provided independently predictive information regarding each test of LBPF.
The opposing effects of ice-induced reduction in foot sole sensation and PN on locomotor system health suggest that the chronic nature of PN allows for the implementation of partially effective compensatory strategies. Yet, the inability to adapt to relatively fast speeds suggests that falls likely occur during challenging situations. The fundamentally different correlates and predictors of LBPF between older adults and those with PN highlight the uniqueness of the movement disorder associated with PN.
Advisor:Peter Wolenski; Jonathan Dingwell; Dennis Landin; Arnold Nelson; Fakhri Al-Bagdadi; Li Li
School:Louisiana State University in Shreveport
School Location:USA - Louisiana
Source Type:Master's Thesis
Date of Publication:07/10/2008