Sains Malaysiana 50(1)(2021): 191-199

http://dx.doi.org/10.17576/jsm-2021-5001-19

The Impact of Diabetic Peripheral Neuropathy on Spatiotemporal Gait Parameters in Stroke Survivors: A Case-Control Study

(Kesan Diabetik Neuropati Periferi ke atas Parameter Berjalan dalam Aspek Masa dan Jarak dalam Kalangan Pesakit Strok: Suatu Kajian Kes Kawalan)

AMIRAH MUSTAPA¹, MARIA JUSTINE², NADIA MOHD MUSTAFAH⁴ & HAIDZIR MANAF^2,3*

¹Department of Physical Rehabilitation Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, 25200 Kuantan, Pahang Darul Makmur, Malaysia

²Centre for Physiotherapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, 42300 Puncak Alam, Selangor Darul Ehsan, Malaysia

³Clinical and Rehabilitation Research Group, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, 42300 Puncak Alam, Selangor Darul Ehsan, Malaysia

⁴Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, 47000 Sungai Buloh, Selangor Darul Ehsan, Malaysia

Diserahkan: 1 Februari 2019/Diterima: 17 Jun 2020

ABSTRACT

The deterioration of gait performance following stroke is related to the impairment of sensorimotor function on the paretic side. Improper gait performance in post-stroke with additional diabetic peripheral neuropathy (DPN) on paretic and non-paretic legs may create destabilizing effects, including serious injuries and falls. Therefore, this study aimed to investigate the effect of DPN on spatiotemporal gait parameters in stroke survivors and determine the correlation of movement functioning and functional balance post-stroke with gait parameters. Ten stroke survivors with DPN, 10 stroke survivors without DPN and 10 healthy controls participated in this case-control study. Movement functioning and functional balance were assessed before the actual testing. Spatiotemporal gait parameters were recorded using the Nexus Vicon motion analysis system. Kruskal-Wallis test was used to analyze the gait parameters and Spearman’s rank-order correlation coefficient was used to identify the correlation between variables. Results showed that stroke survivors with DPN had longer stride time (temporal gait parameter, p = 0.001), lower cadence (p = 0.001) and greater gait variability than those without DPN and the healthy controls. The gait parameters were significantly correlated with movement functioning and functional balance in stroke survivors with DPN (p < 0.05). These findings suggested that DPN possibly affected the gait parameters in stroke survivors. DPN could also play a role in movement functioning and functional balance in stroke survivors.

Keywords: Diabetic peripheral neuropathy; gait; spatiotemporal; stroke

ABSTRAK

Kecelaruan fungsi berjalan dalam kalangan pesakit strok dilaporkan kerana masalah fungsi sensorimotor pada sisi lumpuh. Kecelaruan fungsi berjalan dalam kalangan pesakit strok dengan pertambahan gangguan saraf kaki akibat kencing manis pada sisi lumpuh dan baik boleh menimbulkan kesan buruk yang boleh mempengaruhi risiko jatuh. Oleh itu, kajian ini ingin mengkaji kesan gangguan saraf kaki akibat kencing manis terhadap parameter berjalan dalam aspek masa dan jarak dalam kalangan pesakit strok dan menentukan hubung kait antara fungsi pergerakan, keseimbangn badan dengan parameter berjalan. Sepuluh pesakit strok dengan gangguan saraf kaki akibat kencing manis, 10 pesakit strok yang tiada gangguan saraf kaki akibat kencing manis dan 10 peserta yang sihat telah menyertai kajian ini. Fungsi pergerakan dan keseimbangn badan diuji sebelum ujian yang sebenar. Parameter berjalan dalam aspek masa dan jarak dirakam menggunakan sistem analisis pergerakan Nexus Vicon. Ujian Kruskal-Wallis telah digunakan untuk menganalisis parameter berjalan dan pekali korelasi tataan peringkat Spearman telah digunakan untuk mengenali hubung kait antara pemboleh ubah. Kajian ini menunjukkan pesakit strok dengan gangguan saraf kaki akibat kencing manis mempunyai masa melangkah yang lebih panjang (parameter berjalan dalam aspek masa), jumlah langkah yang rendah dalam satu minit dan kelainan berjalan yang besar daripada pesakit strok yang tiada gangguan saraf kaki akibat kencing manis dan peserta yang sihat. Parameter berjalan mempunyai hubung kait yang signifikan dengan fungsi pergerakan dan keseimbangn badan pada pesakit strok dengan gangguan saraf kaki akibat kencing manis. Keputusan ini mencadangkan parameter berjalan pada pesakit strok terjejas kerana gangguan saraf kaki akibat kencing manis. Gangguan saraf kaki akibat kencing manis juga memainkan peranan penting dalam keterukan strok dan keseimbangn badan.

Kata kunci: Aspek masa dan jarak; berjalan; gangguan saraf kaki akibat kencing manis; strok

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*Pengarang untuk surat-menyurat; email: haidzir5894@uitm.edu.my