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Barsotti E, Goodman B, Samuelson R, Carvour ML. A Scoping Review of Wearable Technologies for Use in Individuals With Intellectual Disabilities and Diabetic Peripheral Neuropathy. J Diabetes Sci Technol 2024:19322968241231279. [PMID: 38439547 DOI: 10.1177/19322968241231279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND Individuals with intellectual disabilities (IDs) are at risk of diabetes mellitus (DM) and diabetic peripheral neuropathy (DPN), which can lead to foot ulcers and lower-extremity amputations. However, cognitive differences and communication barriers may impede some methods for screening and prevention of DPN. Wearable and mobile technologies-such as smartphone apps and pressure-sensitive insoles-could help to offset these barriers, yet little is known about the effectiveness of these technologies among individuals with ID. METHODS We conducted a scoping review of the databases Embase, PubMed, and Web of Science using search terms for DM, DPN, ID, and technology to diagnose or monitor DPN. Finding a lack of research in this area, we broadened our search terms to include any literature on technology to diagnose or monitor DPN and then applied these findings within the context of ID. RESULTS We identified 88 articles; 43 of 88 (48.9%) articles were concerned with gait mechanics or foot pressures. No articles explicitly included individuals with ID as the target population, although three articles involved individuals with other cognitive impairments (two among patients with a history of stroke, one among patients with hemodialysis-related cognitive changes). CONCLUSIONS Individuals with ID are not represented in studies using technology to diagnose or monitor DPN. This is a concern given the risk of DM complications among patients with ID and the potential for added benefit of such technologies to reduce barriers to screening and prevention. More studies should investigate how wearable devices can be used among patients with ID.
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Affiliation(s)
- Ercole Barsotti
- College of Public Health, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Bailey Goodman
- College of Public Health, University of Iowa, Iowa City, IA, USA
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Riley Samuelson
- Hardin Library for the Health Sciences, University of Iowa, Iowa City, IA, USA
| | - Martha L Carvour
- College of Public Health, University of Iowa, Iowa City, IA, USA
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
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Shah VV, Carlson-Kuhta P, Mancini M, Sowalsky K, Horak FB. Digital gait measures, but not the 400-meter walk time, detect abnormal gait characteristics in people with Prediabetes. Gait Posture 2024; 109:84-88. [PMID: 38286063 DOI: 10.1016/j.gaitpost.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 01/04/2024] [Accepted: 01/23/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND AND AIM Abnormal gait characteristics have been observed in people with diabetic neuropathy, but it is unclear if subtle changes in gait occur in prediabetic people with impaired fasting glucose (IFG). The aims of this study were: (1) to investigate if digital gait measures discriminate people with prediabetes from healthy control participants (HC) and (2) to investigate the relationship between gait measures and clinical scores (concurrent validity). METHODS 108 people with prediabetes (71.20 ± 5.11 years) and 63 HC subjects (70.40 ± 6.25 years) wore 6 inertial sensors (Opals by APDM, Clario) while performing the 400-meter fast walk test. Fifty-five measures across 5 domains of gait (Lower Body, Upper Body, Turning, and Variability) were averaged. Analysis of Covariance was used to investigate the group differences, with body mass index as a covariate. Pearson's correlation coefficient assessed the association between the gait measures and the Short Physical Performance Battery (SPPB) score. RESULTS Nine gait measures were significantly different (p < 10-4) between IFG and HC groups. Step duration, cadence, and turn velocity were the most discriminative measures. In contrast, traditional stop-watch time was not significantly different between groups (p = 0.13), after controlling for BMI. Cadence (r = -0.37, p < 0.001), step duration (r = -0.39, p < 0.001), and turn velocity (r = 0.47, p < 0.001) showed a significant correlation with the SPPB score. CONCLUSION Body-worn inertial sensors detected gait impairments in people with prediabetes that related to clinical balance test performance, even when the traditional stop-watch time was not prolonged for the 400-meter walk test.
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Affiliation(s)
- Vrutangkumar V Shah
- APDM Wearable Technologies, a Clario company, Portland, OR, USA; Department of Neurology, Oregon Health & Science University, Portland, OR, USA.
| | | | - Martina Mancini
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | | | - Fay B Horak
- APDM Wearable Technologies, a Clario company, Portland, OR, USA; Department of Neurology, Oregon Health & Science University, Portland, OR, USA
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Efthymiou D, Katsiki N, Zekakos DX, Vassiliadis P, Petrelis A, Vassilopoulou E. Gait Analysis, Metabolic Parameters and Adherence to the Mediterranean Diet in Patients with Type 2 Diabetes Mellitus Compared with Healthy Controls: A Pilot Study. Nutrients 2023; 15:3421. [PMID: 37571358 PMCID: PMC10420976 DOI: 10.3390/nu15153421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Patients with type 2 diabetes mellitus (T2DM) are prone to developing diabetic peripheral neuropathy (DPN) with an increased risk of injuries while walking, potentially leading to plantar ulcers. We aimed to assess the early gait changes in T2DM patients without clinical signs of DPN in comparison to age-matched healthy controls (HC). SUBJECTS AND METHODS One hundred T2DM patients (78 women, mean age: 66.4 ± 11.5 years) and 50 age-matched HC (34 women, mean age 62.1 ± 7.9 years) were evaluated with the PODOSmart® gait analysis device. Anthropometric and biochemical data, as well as dietary habits were collected for all participants. T2DM patients also completed the Diabetes Distress (DS) self-report validated questionnaire. RESULTS One patient was excluded from the study due to lack of recent biochemical data. Among the T2DM patients, 88.9% reported little or no DS and 11.1% moderate DS. The T2DM group had higher body mass index, waist circumference, systolic blood pressure, glycated hemoglobin A1c, sodium, white blood cell count, triglycerides and low-density lipoprotein cholesterol, but lower high-density lipoprotein cholesterol than HC (p < 0.05 for all comparisons). The MedDiet score was satisfactory in both groups (p > 0.05). Significant differences were found between the two study groups in gaitline heel off, propulsion speed, foot progression angle, time taligrade phase, stride length, walking speed, angle attack, oscillation speed, pronation-supination toe off and clearance. CONCLUSIONS The T2DM patients without self-reported DS or clinical signs of DPN may exhibit significant differences in several gait parameters analyzed with PODOSmart®. Whether gait analysis can be used as an early diagnostic tool of T2DM complications should be further explored.
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Affiliation(s)
| | - Niki Katsiki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece;
- School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus
| | | | | | | | - Emilia Vassilopoulou
- Nous Therapy Center, 1 Aggelaki Street, 54621 Thessaloniki, Greece;
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece;
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Hoveizavi R, Gao F, Ramirez VJ, Shuman BR, Joiner JC, Fisher SJ. Compromised neuromuscular function of walking in people with diabetes: a narrative review. Diabetes Res Clin Pract 2023:110802. [PMID: 37356728 DOI: 10.1016/j.diabres.2023.110802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 04/18/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023]
Abstract
AIM This review summarizes recent studies that have investigated the neuromuscular dysfunction of walking in people with diabetes and its relationship to ulcer formation. METHODS A comprehensive electronic search in the database (Scopus, Web of Science, PsycINFO, ProQuest, and PubMed) was performed for articles pertaining to diabetes and gait biomechanics. RESULTS The Achilles tendon is thicker and stiffer in those with diabetes. People with diabetes demonstrate changes in walking kinematics and kinetics, including slower self-selected gait speed, shorter stride length, longer stance phase duration, and decreased ankle, knee, and metatarsophalangeal (MTP) joint range of motion. EMG is altered during walking and may reflect diabetes-induced changes in muscle synergies. Synergies are notable because they provide a more holistic pattern of muscle activations and can help develop better tools for characterizing disease progression. CONCLUSION Diabetes compromises neuromuscular coordination and function. The mechanisms contributing to ulcer formation are incompletely understood. Diabetes-related gait impairments may be a significant independent risk factor for the development of foot ulcers.
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Affiliation(s)
- Roya Hoveizavi
- Department of Kinesiology and Health promotions, University of Kentucky, Lexington, KY, USA.
| | - Fan Gao
- Department of Kinesiology and Health promotions, University of Kentucky, Lexington, KY, USA.
| | - Vanessa J Ramirez
- US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Benjamin R Shuman
- RR&D Center for Limb Loss and MoBility (CLiMB), Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Joshua C Joiner
- College of Medicine, University of Kentucky, Lexington, KY, USA.
| | - Simon J Fisher
- Division of Endocrinology, Diabetes and Metabolism, Dept. of Internal Medicine, University of Kentucky, Lexington, KY, USA.
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Martin JK, Davis BL. Diabetic Foot Considerations Related to Plantar Pressures and Shear. Foot Ankle Clin 2023; 28:13-25. [PMID: 36822683 PMCID: PMC10111339 DOI: 10.1016/j.fcl.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Diabetic foot ulcers are a complex, multifaceted, and widespread complication of diabetes mellitus. Although there are a multitude of risk factors contributing to diabetic foot ulcer development, pressure and (more recently) shear stresses are two biomechanical metrics that are gaining popularity for monitoring risk factors predisposing skin breakdown. Other areas of diabetic foot ulcers under research include plantar temperature measuring, as well as monitoring wear-time compliance and machine learning/AI algorithms. Charcot arthropathy is another diabetes complication that has a relationship with diabetic foot ulcer development, which should be monitored for development alongside ulcer development. The ability to monitor and prevent diabetic foot ulcer development and Charcot neuroarthropathy will lead to increased patient outcomes and patient quality of life.
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Affiliation(s)
- Jessi K Martin
- Center for Human Machine Systems, Cleveland State University, WH 305, Cleveland, OH 44115, USA
| | - Brian L Davis
- Center for Human Machine Systems, Cleveland State University, WH 305, Cleveland, OH 44115, USA.
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Low WS, Chan CK, Chuah JH, Tee YK, Hum YC, Salim MIM, Lai KW. A Review of Machine Learning Network in Human Motion Biomechanics. JOURNAL OF GRID COMPUTING 2022; 20:4. [DOI: 10.1007/s10723-021-09595-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 11/28/2021] [Indexed: 07/26/2024]
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Favretto MA, Cossul S, Andreis FR, Nakamura LR, Ronsoni MF, Tesfaye S, Selvarajah D, Marques JLB. Alterations of tibialis anterior muscle activation pattern in subjects with type 2 diabetes and diabetic peripheral neuropathy. Biomed Phys Eng Express 2022; 8. [PMID: 34933285 DOI: 10.1088/2057-1976/ac455b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 12/21/2021] [Indexed: 11/11/2022]
Abstract
Diabetic peripheral neuropathy (DPN) is associated with loss of motor units (MUs), which can cause changes in the activation pattern of muscle fibres. This study investigated the pattern of muscle activation using high-density surface electromyography (HD-sEMG) signals from subjects with type 2 diabetes mellitus (T2DM) and DPN. Thirty-five adults participated in the study: 12 healthy subjects (HV), 12 patients with T2DM without DPN (No-DPN) and 11 patients with T2DM with DPN (DPN). HD-sEMG signals were recorded in the tibialis anterior muscle during an isometric contraction of ankle dorsiflexion at 50% of the maximum voluntary isometric contraction (MVIC) during 30-s. The calculated HD-sEMG signals parameters were the normalised root mean square (RMS), normalised median frequency (MDF), coefficient of variation (CoV) and modified entropy (ME). The RMS increased significantly (p = 0.001) with time only for the DPN group, while the MDF decreased significantly (p < 0.01) with time for the three groups. Moreover, the ME was significantly lower (p = 0.005), and CoV was significantly higher (p = 0.003) for the DPN group than the HV group. Using HD-sEMG, we have demonstrated a reduction in the number of MU recruited by individuals with DPN. This study provides proof of concept for the clinical utility of this technique for identifying neuromuscular impairment caused by DPN.
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Affiliation(s)
- M A Favretto
- Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - S Cossul
- Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - F R Andreis
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - L R Nakamura
- Department of Informatics and Statistics, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - M F Ronsoni
- Department of Endocrinology and Metabolism, University Hospital, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - S Tesfaye
- Diabetes Research Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - D Selvarajah
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - J L B Marques
- Institute of Biomedical Engineering, Department of Electrical and Electronic Engineering, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
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Kujawski S, Kujawska A, Perkowski R, Androsiuk-Perkowska J, Hajec W, Kwiatkowska M, Skierkowska N, Husejko J, Bieniek D, Newton JL, Morten KJ, Zalewski P, Kędziora-Kornatowska K. Cognitive Function Changes in Older People. Results of Second Wave of Cognition of Older People, Education, Recreational Activities, NutritIon, Comorbidities, fUnctional Capacity Studies (COPERNICUS). Front Aging Neurosci 2021; 13:653570. [PMID: 34025391 PMCID: PMC8134550 DOI: 10.3389/fnagi.2021.653570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/05/2021] [Indexed: 12/20/2022] Open
Abstract
Background Cognitive reserve explains why subjects with more years of education, professional achievement, or participation in recreational activities show less cognitive decline with aging. We hypothesize that levels of recreational travel, education, occupation, systemic health, physical performance, and current cognitive activity levels affect the trajectory of cognitive function in older, healthy people in Poland. Materials and Methods Healthy, older people (N = 205) were examined and followed-up at 2 years. Participants completed physical and cognitive function assessments: including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and its two subtests Delayed Recall (DR) and Verbal Fluency (VF), and Trail Making Test Part B (TMT B). Factors associated with cognitive functioning were also examined. Results The MMSE result significantly decreased over 2 years. No significant decrease in other cognitive tests was noted. However, the trajectory of cognitive tests results varied between individual participants. Percentage of variance of change was explained by the following predictors: 21 in MMSE, 24 in MoCA, 8 in DR, 25 in VF, and 24 in TMT B. Age and the presence of varicose veins were significantly linked to negative changes in MMSE and MoCA scores, while working in a professional occupational status associated with a higher score. The subgroup with varicose veins did worse on the Delayed Recall subtest of MoCA. Conclusion Cognitive reserve could be extended by proxies of reserve that are related to systemic health and travel activity. The latter is a combination of social, physical, and cognitive activity and potentially might serve as an intervention to improve cognitive function in older people. However, due to the limitations of this study, results should be interpreted with caution and needs to be replicated in the further studies.
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Affiliation(s)
- Sławomir Kujawski
- Department of Hygiene, Epidemiology, Ergonomics and Postgraduate Training, Division of Ergonomics and Exercise Physiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Agnieszka Kujawska
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland.,Department of Physiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Radosław Perkowski
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Joanna Androsiuk-Perkowska
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Weronika Hajec
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Małgorzata Kwiatkowska
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Natalia Skierkowska
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Jakub Husejko
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Daria Bieniek
- Department of Gastroenterology and Nutrition Disorders, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Julia L Newton
- Population Health Sciences Institute, The Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Karl J Morten
- Nuffield Department of Women's and Reproductive Health, The Women Centre, University of Oxford, Oxford, United Kingdom
| | - Paweł Zalewski
- Department of Hygiene, Epidemiology, Ergonomics and Postgraduate Training, Division of Ergonomics and Exercise Physiology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
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Booij MJ, Meinders E, Sierevelt IN, Nolte PA, Harlaar J, van den Noort JC. Matching walking speed of controls affects identification of gait deviations in patients with a total knee replacement. Clin Biomech (Bristol, Avon) 2021; 82:105278. [PMID: 33540284 DOI: 10.1016/j.clinbiomech.2021.105278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/15/2021] [Accepted: 01/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The assessment of functional recovery of patients after a total knee replacement includes the quantification of gait deviations. Comparisons to comfortable gait of healthy controls may incorrectly suggest biomechanical gait deviations, since the usually lower walking speed of patients already causes biomechanical differences. Moreover, taking peak values as parameter might not be sensitive to actual differences. Therefore, this study investigates the effect of matching walking speed and full-waveform versus discrete analyses. METHODS Gait biomechanics of 25 knee replacement patients were compared to 22 controls in two ways: uncorrected and corrected for walking speed employing principal component analyses, to reconstruct control gait biomechanics at walking speeds matched to the patients. Ankle, knee and hip kinematics and kinetics were compared over the full gait cycle using statistical parametric mapping against using peak values. FINDINGS All joint kinematics and kinetics gait data were impacted by applying walking speed correction, especially the kinetics of the knee. The lower control walking speeds used for reference generally reduced the magnitude of differences between patient and control gait, however some were enlarged. Full-waveform analysis identified greater deviating gait cycle regions beyond the peaks, but did not make peak value analyses redundant. INTERPRETATION Matching walking speed of controls affects identification of gait deviations in patients with a total knee replacement, reducing deviations confounded by walking speed and revealing hidden gait deviations related to possible compensations. Full-waveform analysis should be used along peak values for a comprehensive quantification of differences in gait biomechanics.
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Affiliation(s)
- M J Booij
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands.
| | - E Meinders
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands
| | - I N Sierevelt
- Specialized Centre of Orthopedic Research and Education (SCORE), Xpert Orthopedics, Laarderhoogtweg 12, Amsterdam, the Netherlands; Spaarne Gasthuis Academy, Department of Orthopaedic Surgery, Spaarnepoort 1, Hoofddorp, the Netherlands
| | - P A Nolte
- Spaarne Gasthuis Academy, Department of Orthopaedic Surgery, Spaarnepoort 1, Hoofddorp, the Netherlands
| | - J Harlaar
- Delft University of Technology, Department of Biomechanical Engineering, Mekelweg 2, Delft, the Netherlands; Erasmus Medical Center, Department of Orthopaedics & Sports Medicine, Dr. Molewaterplein 40, Rotterdam, the Netherlands
| | - J C van den Noort
- Amsterdam UMC, University of Amsterdam, Department of Radiology and Nuclear Medicine, Medical Imaging Quantification Center, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
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Bernetti A, Agostini F, de Sire A, Mangone M, Tognolo L, Di Cesare A, Ruiu P, Paolucci T, Invernizzi M, Paoloni M. Neuropathic Pain and Rehabilitation: A Systematic Review of International Guidelines. Diagnostics (Basel) 2021; 11:diagnostics11010074. [PMID: 33466426 PMCID: PMC7824970 DOI: 10.3390/diagnostics11010074] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/24/2020] [Accepted: 01/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Neuropathic pain is an injury or disease of the central and/or peripheral somatosensory nervous system, and it has a significant impact on quality of life, especially since it is often refractory to treatment. Rehabilitative intervention is considered in various guidelines on neuropathic pain treatment, although not in an organic nor detailed way. The aim of this systematic review was to analyze the most indicated therapeutic strategies, providing rehabilitative recommendations in the management of neuropathic pain. Methods: A systematic review was performed according to PRISMA guidelines. The scientific search, carried out until July 2020, considered guidelines in English language of the last thirteen years. Results: Six guidelines were analyzed, from which emerges that a multidisciplinary approach, comprehensive of pharmacologic and nonpharmacologic interventions, should drive neuropathic pain management. A relevant role in non-pharmacological intervention is played by rehabilitation, through an adequate tailored rehabilitation program and physical therapies. Conclusion: This analysis highlights the importance of rehabilitation but also the lack of evidence on various rehabilitative practices. Arises hence the need for further studies in this field to better define a rehabilitative treatment strategy.
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Affiliation(s)
- Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (A.D.C.); (P.R.); (M.P.)
- Correspondence: ; Tel.: +39-3209467954
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (A.D.C.); (P.R.); (M.P.)
| | - Alessandro de Sire
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (A.d.S.); (M.I.)
- Rehabilitation Unit, “Mons. L. Novarese” Hospital, 13040 Moncrivello, Italy
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (A.D.C.); (P.R.); (M.P.)
| | - Lucrezia Tognolo
- Department of Neurosciences, University of Padua, 35121 Padua, Italy;
| | - Annalisa Di Cesare
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (A.D.C.); (P.R.); (M.P.)
| | - Pierangela Ruiu
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (A.D.C.); (P.R.); (M.P.)
| | - Teresa Paolucci
- Department of Medical and Oral Sciences and Biotechnologies, University of G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (A.d.S.); (M.I.)
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (A.D.C.); (P.R.); (M.P.)
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11
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Tian T, Wang C, Xu Y, Bai Y, Wang J, Long Z, Wang X, Zhou L. A Wearable Gait Analysis System Used in Type 2 Diabetes Mellitus Patients: A Case-Control Study. Diabetes Metab Syndr Obes 2021; 14:1799-1808. [PMID: 33935508 PMCID: PMC8079258 DOI: 10.2147/dmso.s305102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/01/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Previous studies have shown that the gait of patients with type-2 diabetes mellitus is abnormal compared with the healthy group. Currently, a three-dimensional motion analyzer system is commonly used for gait analysis. However, it is challenging to collect data and use in clinical study due to extensive experimental conditions and high price. In this study, we used a wearable gait analysis system (Gaitboter) to investigate the spatial and temporal parameters, and kinematic data of gait in diabetic patients, especially those with peripheral neuropathy. The aim of the study is to evaluate the wearable gait analysis system in diabetic study. MATERIALS AND METHODS We conducted a case-control study to analyze the gait of type 2 diabetes mellitus. Gaitboter was used to detect and collect gait data in the ward of Beijing Chao-yang Hospital, Capital Medical University from June 2018 to October 2018. We collected the gait data of participants (N= 146; 73 patients with type 2 diabetes, 16 with peripheral neuropathy and 57 without peripheral neuropathy, and 73 matched controls). The gait data (stance phase, swing phase, double-foot stance phase, single-foot stance phase, walking cadence, stride length, walking speed, off-ground angle, landing angle, maximum swing angle, minimum swing angle, and foot progression angle) in diabetic patients were recorded and compared with controls. SPSS 22.0 statistical software was used to analyzed the gait parameter data. RESULTS We found that the landing angle and the maximum swing angle of diabetes patients with or without peripheral neuropathy were significantly less than those of the control group (P < 0.05). The walking speed of diabetes patients with peripheral neuropathy is significantly less than those of the control group (P < 0.05). CONCLUSION This study confirms that the wearable gait analysis system (Gaitboter) is an ideal system to identify abnormal gait in patients with type 2 diabetes and provides a new device and method for diabetes-related gait research.
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Affiliation(s)
- Tian Tian
- General Practice Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Cheng Wang
- Institute of Digital Economy Industry, ICT, Hangzhou, People’s Republic of China
- Luoyang Institute of Information Technology Industries, Luoyang, People’s Republic of China
- Ningbo Institute of Information Technology Application, CAS, Ningbo, People’s Republic of China
| | - Yuan Xu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
- Correspondence: Yuan Xu Email
| | - Yuzhi Bai
- General Practice Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Jing Wang
- General Practice Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zhou Long
- Institute of Digital Economy Industry, ICT, Hangzhou, People’s Republic of China
- Luoyang Institute of Information Technology Industries, Luoyang, People’s Republic of China
| | - Xiangdong Wang
- Institute of Computing Technology (ICT), Chinese Academy of Sciences (CAS), Beijing, People’s Republic of China
- Beijing Key Laboratory of Mobile Computing and Pervasive Device, Beijing, People’s Republic of China
| | - Lichun Zhou
- Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
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