Interventions Improve Gait Regularity in Patients with Peripheral Neuropathy While Walking on an Irregular Surface Under Low Light

Abstract

To determine which, if any, of three inexpensive interventions improve gait regularity in patients with peripheral neuropathy (PN) while walking on an irregular surface under low-light conditions. Design : Observational. Setting : University of Michigan Biomechanics Research Laboratory. Participants : Forty-two patients with PN (20 women), mean age±standard deviation=64.5±9.7. Interventions : A straight cane, touch of a vertical surface, or semirigid ankle orthoses. Measurements : Step-width variability and range, step-time variability, and speed. Results : Subjects demonstrated significantly less step-width variability (mean=41.0±1.5, 36.9±1.6, 37.2±1.3, and 35.9±1.5 mm for baseline, cane, orthoses, and vertical surface, respectively; P< .0001) and range (182.7±7.4, 163.7±8.3, 164.3±7.4, 154.3±6.9 mm for baseline, cane, orthoses and vertical surface, respectively; P= .0006) with each of the interventions than under baseline conditions. Step-time variability significantly decreased with use of the orthoses and vertical surface but not the cane ( P= .0001). Use of a cane, but not orthoses or vertical surface, was associated with decreased speed (0.79±0.03, 0.73±0.03, 0.79±0.03, 0.80±0.03 m/s for baseline, cane, orthoses, and vertical surface, respectively; P= .0001). Conclusion : Older patients with PN demonstrate improved spatial and temporal measures of gait regularity with the use of a cane, ankle orthoses, or touch of a vertical surface while walking under challenging conditions. The decreased speed and stigma associated with the cane and uncertain availability of a vertical surface suggest that the ankle orthoses may be the most practical intervention.