A comparison of gait characteristics between older women with and without peripheral neuropathy on smooth and unlevel surfaces

OBJECTIVES: To compare gait patterns in older womenwith and without peripheral neuropathy (PN) in standard(smooth surface, normal lighting) and challenging environments (CE) (irregular surface, low lighting).DESIGN: Observational, controlled study of 24 subjects.SETTING: Biomechanical research laboratory.PARTICIPANTS: Twenty-four older women, 12 with PNand 12without PN (mean age � standard deviation 567.1 �7.9 and 70.2 � 4.3, respectively).MEASUREMENTS: Gait parameters and, in the 12 PNsubjects, neuropathy severity.RESULTS: The CE was associated with increases in stepwidth, step-width variability, step-width range, step width–to–step length ratio, step time and step-time variability, and decreases in step length and speed. The PN subjects demonstrated a greater step width–to–step length ratio and step time and shorter step length and slower speed than the control subjects. In adapting to the CE, the PN subjects demonstrated greater increases in step width–to–step length ratio and step-time variability and a greater decrease in step length than did the control subjects. In the standard environment, only one gait parameter correlated with PN severity, whereas in the CE, four gait parameters did so. CONCLUSION: The subjects demonstrated a gait thatwas slower, less efficient, and more variable temporally and in the frontal plane in the CE. Control and PN subjectsdemonstrated similar variability in medial-lateral stepplacement in the CE but at the cost of speed and efficiencyfor the PN subjects. Because the CE magnified gait differences between the two groups of subjects and caused gait changes in the PN subjects that correlated with PN severity, the CE may offer improved resolution for detecting gait abnormalities