Motor Learning in Gait in Subjects With Diabetic Peripheral Neuropathy
研究概览
详细说明
This study suggests that teaching a new strategy is beneficial to decrease the forefoot peak plantar pressure in individuals who are susceptible to plantar ulcerations. It has not, however, been studied whether these changes would be maintained long-term or if they had any effect on the ulceration rate. Additionally, no analysis of the amount of visual feedback necessary to elicit the desired motor pattern was discussed. It has been suggested that proprioception plays an integral role in the use of feedback to develop error-detection mechanisms by integrating visual feedback and kinesthetic variables. In the diabetic peripheral neuropathy subject population, proprioception and kinesthesia may be compromised. This may have effects on the ability of this population to maintain changes in inappropriate movement patterns. A significant portion of patients continue to develop plantar ulcers even with prescriptive footwear compliance, so gait training to change inappropriate patterns which result in the high plantar pressures may be critical to prevent ulceration.
Comparisons: Two groups of subjects will receive gait training, one group will receive feedback of performance while the other will only receive training, and one control group. Comparisons will include whether plantar pressures are decreased in the training groups, and if those changes are maintained long-term.
研究类型
注册 (预期的)
阶段
- 不适用
联系人和位置
学习地点
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California
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West Los Angeles、California、美国、90073
- VA Greater Los Angeles Healthcare System, West LA
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Diagnosis of diabetes for at least one year.
- Diabetic peripheral neuropathy as defined by failure to sense the 5.07 (10g) monofilament test in one or more of the six sites tested (31;32)
- Age 50-80 years old
- Able to ambulate independently without assistive devices (e.g. walker or crutches) (8) for 30 feet.
- No evidence of neurological (other than peripheral neuropathy) or orthopedic conditions
Exclusion Criteria:
- Other non-diabetic causes of neuropathy by history
- Symptomatic peripheral vascular disease
- Joint pain, swelling and/or limited of range of motion in the lower extremities that interfere with walking or exercise
- Visual problems not correctable with glasses or contact lens
Passive range of motion limitations are described as:
- Hip flexion < 1000;
- Hip extension < 200;
- Knee flexion < 1250;
- Knee extension < 00 (unable to obtain full extension);
- Ankle plantar flexion < 250;
- Ankle dorsiflexion < 150
- Other systemic or local diseases that could interfere with walking assessment
- Severe systemic diseases other than diabetes or its complications, especially those interfering with exercise tolerance
- Amputation in the lower extremities
- Terminal illness
- Severe obesity: BMI>30 kg/m2 (33)
- Severe foot deformities (e.g. flexion contracture of the toes, pes cavus, Charcot disease)
- Mini-mental status of <27 or diagnosis of dementia
- History of alcohol or drug abuse
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
其他:1个
|
研究衡量的是什么?
主要结果指标
结果测量 |
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Plantar Pressure
|
合作者和调查者
调查人员
- 首席研究员:Karen Perell, PhD RKT、VA Greater Los Angeles Healthcare System, West LA
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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