Gait characteristics in people with type 2 diabetes mellitus

Sixteen control subjects and 15 subjects with type 2 diabetes were examined to compare gait characteristics during walking in a linear path and in turns of 0.33 and 0.66 m diameter. Subjects were excluded if there was diminished sensation in the feet or impairment of strength in the legs. This was done to isolate the effect of diabetes gait independent of loss of sensation. Gait was assessed through contact sensors on the foot, video, and two axis accelerometers mounted bilaterally on the head, shoulders, hips, knees and ankles. The results of these experiments showed that subjects with diabetes walked significantly slower (P<0.05) than control subjects and with a wider stance (P<0.01), both for walking in a linear path (velocity of subjects with diabetes was 62.2% that of controls and stance was 134.9% wider than controls) and when making turns (velocity 50.6% of controls and stance 120.1% wider than that of controls). Accelerometry showed increased flexion/extension and lateral movement of the major joints in subjects with diabetes during both walking in a linear path and turns compared to control subjects. Part of the increased movement at the joints in the subjects with diabetes was due to tremor in both the 8 Hz and 16 Hz bands. These findings suggest that at least some of the increased joint movement during walking in people with diabetes is likely neurological in origin and not related to muscle weakness or loss of sensation in the feet.