Inter-Joint Coordination of the Lower Limb Joints in Patients with Diabetes Mellitus During Obstacle-Crossing

Patients with type II diabetes mellitus (DM) have been reported to be at a high risk of falling which may be related to the presence of multiple risk factors, including the disease itself, problems with gait and balance, and peripheral neuropathy (PN). The purpose of this study was to compare the joint kinematics and inter-joint coordination of the lower extremities between healthy subjects and individuals with DM during obstacle-crossing with the leading limb. With significant changes of the joint kinematics, patients with DM changed significantly the way the motions of the lower limb joints were coordinated during obstacle-crossing in a stable fashion. Although the stable inter-joint coordination may enable the patients with DM to accommodate reliably the mechanical demands related to DM complications during obstacle-crossing, the altered inter-joint coordination control with reduced swing toe-clearance may increase the risk of falling during obstacle-crossing. It is suggested that patients with type II DM, with no to minimal PN, should also be targeted for fall prevention.