Diabetes Clinical Trial
Official title:
Motor Learning in Gait in Subjects With Diabetic Peripheral Neuropathy
The purpose of this study is to determine whether individuals with diabetic peripheral neuropathy can learn to change the way they walk in order to reduce the pressures underneath the feet, which may lead to a reduced risk of foot ulceration.
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.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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