Gait, balance and peripheral sensitivity analysis in elderly people with type 2 diabetes mellitus: a case-control study
Abstract
This study aimed to identify functional, sensory, and biomechanical alterations in older adults with type 2 diabetes mellitus (T2DM) without clinical peripheral neuropathy. An observational, analytical case-control study was conducted at the LIBiAM Laboratory, CENUR L.N., in Paysandú (Uruguay). Eighteen patients with T2DM (experimental group, EG, 69 ± 3.5 years) and twenty-two age- and gender-matched controls (control group, CG, 68.5 ± 3.5 years) participated. Assessments included functional tests (SPPB), protective sensitivity using Semmes-Weinstein monofilaments, and kinematic and metabolic gait analysis on a treadmill at different speeds. Statistical analyses used a significance level of p < 0.05.
The EG showed a lower self-selected walking speed (1.05 ± 0.14 m/s vs. 1.20 ± 0.20 m/s; p = 0.041) and a higher proportion of abnormal responses to the 4 g monofilament (27.8% vs. 0%; p = 0.015). During gait, they exhibited lower step frequency (p = 0.0017), longer relative stance time (p = 0.0345), and a decoupling between step frequency and length, with no differences in metabolic cost or mechanical efficiency.
These findings reveal subclinical neuromuscular and sensory impairments in T2DM, despite preservation of pendular mechanics and energy cost. Early detection of these changes may guide preventive interventions aimed at maintaining mobility and reducing risks in this population.
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