Muscle force distribution of the lower limbs during walking in diabetic individuals with and without polyneuropathy

dc.contributor.authorGomes A.A.
dc.contributor.authorAckermann M.
dc.contributor.authorFerreira J.P.
dc.contributor.authorOrselli M.I.V.
dc.contributor.authorSacco I.C.N.
dc.date.accessioned2019-08-20T00:13:07Z
dc.date.available2019-08-20T00:13:07Z
dc.date.issued2017
dc.description.abstract© 2017 The Author(s).Background: Muscle force estimation could advance the comprehension of the neuromuscular strategies that diabetic patients adopt to preserve walking ability, which guarantees their independence as they deal with their neural and muscular impairments due to diabetes and neuropathy. In this study, the lower limb's muscle force distribution during gait was estimated and compared in diabetic patients with and without polyneuropathy. Methods: Thirty individuals were evaluated in a cross-sectional study, equally divided among controls (CG) and diabetic patients with (DNG) and without (DG) polyneuropathy. The acquired ground reaction forces and kinematic data were used as input variables for a scaled musculoskeletal model in the OpenSim software. The maximum isometric force of the ankle extensors and flexors was reduced in the model of DNG by 30% and 20%, respectively. The muscle force was calculated using static optimization, and peak forces were compared among groups (flexors and extensors of hip, knee, and ankle; ankle evertors; and hip abductors) using MANOVAs, followed by univariate ANOVAs and Newman-Keuls post-hoc tests (p < 0.05). Results: From the middle to late stance phase, DG showed a lower soleus muscle peak force compared to the CG (p=0.024) and the DNG showed lower forces in the gastrocnemius medialis compared to the DG (p=0.037). At the terminal swing phase, the semitendinosus and semimembranosus peak forces showed lower values in the DG compared to the CG and DNG. At the late stance, the DNG showed a higher peak force in the biceps short head, semimembranosus, and semitendinosus compared to the CG and DG. Conclusion: Peak forces of ankle (flexors, extensors, and evertors), knee (flexors and extensors), and hip abductors distinguished DNG from DG, and both of those from CG. Both diabetic groups showed alterations in the force production of the ankle extensors with reductions in the forces of soleus (DG) and gastrocnemius medialis (DNG) seen in both diabetic groups, but only DNG showed an increase in the hamstrings (knee flexor) at push-off. A therapeutic approach focused on preserving the functionality of the knee muscles is a promising strategy, even if the ankle dorsiflexors and plantarflexors are included in the resistance training.
dc.description.firstpage111
dc.description.issuenumber1
dc.description.volume14
dc.identifier.citationGOMES, ALINE A.; Ackermann, Marko; FERREIRA, JEAN P.; ORSELLI, MARIA ISABEL V.; SACCO, ISABEL C. N.. Muscle force distribution of the lower limbs during walking in diabetic individuals with and without polyneuropathy. Journal of NeuroEngineering and Rehabilitation, v. 14, n. 1, p. 111, 2017.
dc.identifier.doi10.1186/s12984-017-0327-x
dc.identifier.issn1743-0003
dc.identifier.urihttps://repositorio.fei.edu.br/handle/FEI/1872
dc.relation.ispartofJournal of NeuroEngineering and Rehabilitation
dc.rightsAcesso Aberto
dc.subject.otherlanguageBiomechanics
dc.subject.otherlanguageComputer simulation
dc.subject.otherlanguageDiabetic neuropathies
dc.subject.otherlanguageGait
dc.titleMuscle force distribution of the lower limbs during walking in diabetic individuals with and without polyneuropathy
dc.typeArtigo
fei.scopus.citations23
fei.scopus.eid2-s2.0-85033725914
fei.scopus.subjectAdult
fei.scopus.subjectAnkle
fei.scopus.subjectBiomechanical Phenomena
fei.scopus.subjectCross-Sectional Studies
fei.scopus.subjectDiabetes Mellitus
fei.scopus.subjectDiabetic Neuropathies
fei.scopus.subjectFemale
fei.scopus.subjectGait Disorders, Neurologic
fei.scopus.subjectHip
fei.scopus.subjectHumans
fei.scopus.subjectKnee
fei.scopus.subjectLower Extremity
fei.scopus.subjectMale
fei.scopus.subjectMiddle Aged
fei.scopus.subjectMuscle, Skeletal
fei.scopus.subjectWalking
fei.scopus.updated2024-02-01
fei.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85033725914&origin=inward
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