Lower limb electromygraphy and kinematics of neuropathic diabetic patients during real-life activities: stair negotiation.

INTRODUCTION In this study we investigate the influence of diabetic neuropathy (DN) on lower limb electromyography (EMG) and kinematics during stair negotiation. METHODS Forty-six adults (healthy and DN) performed stair ascent and descent tasks. Kinematic and EMG data were assessed unilaterally. RESULTS DN patients had lower ankle dorsiflexion while ascending and plantarflexion while descending. This reduced dorsiflexion compromises proper ankle and knee positions necessary for an efficient lifting action by the vastus lateralis (VL). The mechanical disadvantage of VL at the beginning of the stance triggered prolonged VL activation at the end of stair ascent. In stair descent, DN patients showed lower tibialis anterior activity in the early phase that can potentially impair the mechanism of impact absorption when the forefoot contacts the step. CONCLUSIONS Our results reveal an adaptive motor strategy in DN patients to overcome the challenge of stair ascent, which promoted more biomechanical deficits.