Compromised neuromuscular function of walking in people with diabetes: A narrative review

Roya Hoveizavi; Fan Gao; Vanessa J. Ramirez; Benjamin R. Shuman; Joshua C. Joiner; Simon J. Fisher

doi:10.1016/j.diabres.2023.110802

Compromised neuromuscular function of walking in people with diabetes: A narrative review

Roya Hoveizavi
, Fan Gao
, Vanessa J. Ramirez
, Benjamin R. Shuman
, Joshua C. Joiner
, Simon J. Fisher

Research output: Contribution to journal › Review article › peer-review

3 Scopus citations

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.

Original language	English
Article number	110802
Journal	Diabetes Research and Clinical Practice
Volume	202
DOIs	https://doi.org/10.1016/j.diabres.2023.110802
State	Published - Aug 2023

Bibliographical note

Publisher Copyright:
© 2023 Elsevier B.V.

Funding

Funding : This work was supported by the teaching assistantship provided by the Department of Kinesiology and Health Promotions in University of Kentucky (R.H.), Graduate Student Research Award- Department of Kinesiology and Health Promotions, University of Kentucky (R.H.), Arvle and Turner Thacker Research Fund (R.H.), John Edwin Partington and Gwendolyn Gray Partington Scholarship (R.H.), the National Institute of Diabetes and Digestive and Kidney Disease (R01DK118082) (S.J.F.), and the Barnstable Brown Diabetes Center and University of Kentucky Diabetes and Obesity Research Priority Area (S.J.F).

Funders	Funder number
Arvle and Ellen Turner Thacker Research Fund
Department of Kinesiology and Health Promotions
Department of Kinesiology and Health Promotions in University of Kentucky
John Edwin Partington and Gwendolyn Gray Partington Scholarship
Kentucky Diabetes and Obesity Research Priority Area
National Institute of Diabetes and Digestive and Kidney Diseases	R01DK118082
University of Kentucky

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Achilles tendon
Biomechanics
Diabetes
Gait
Muscle synergy
Plantar ulcers

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Endocrinology

Access to Document

10.1016/j.diabres.2023.110802

Cite this

@article{52b816924a4c49769f21dd39180227d0,

title = "Compromised neuromuscular function of walking in people with diabetes: A narrative review",

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.",

keywords = "Achilles tendon, Biomechanics, Diabetes, Gait, Muscle synergy, Plantar ulcers",

author = "Roya Hoveizavi and Fan Gao and Ramirez, \{Vanessa J.\} and Shuman, \{Benjamin R.\} and Joiner, \{Joshua C.\} and Fisher, \{Simon J.\}",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier B.V.",

year = "2023",

month = aug,

doi = "10.1016/j.diabres.2023.110802",

language = "English",

volume = "202",

}

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T1 - Compromised neuromuscular function of walking in people with diabetes

T2 - A narrative review

AU - Hoveizavi, Roya

AU - Gao, Fan

AU - Ramirez, Vanessa J.

AU - Shuman, Benjamin R.

AU - Joiner, Joshua C.

AU - Fisher, Simon J.

PY - 2023/8

Y1 - 2023/8

N2 - 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.

AB - 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.

KW - Achilles tendon

KW - Biomechanics

KW - Diabetes

KW - Gait

KW - Muscle synergy

KW - Plantar ulcers

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DO - 10.1016/j.diabres.2023.110802

M3 - Review article

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AN - SCOPUS:85164362264

SN - 0168-8227

VL - 202

JO - Diabetes Research and Clinical Practice

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M1 - 110802

ER -

Compromised neuromuscular function of walking in people with diabetes: A narrative review

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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Cite this