# Alterations in lower limb kinematics and moments in partial foot amputation versus diabetic neuropathy

## TL;DR

This study compares gait patterns in people with partial foot amputation and those with diabetic neuropathy, finding similar compensatory movements that suggest neuropathy is the main cause of gait issues.

## Contribution

The study identifies that peripheral neuropathy, not the amputation itself, is the primary driver of gait alterations in partial foot amputation cases.

## Key findings

- Both groups showed similar sagittal plane kinematics and moments, with excessive dorsiflexion during stance.
- The late stance phase was most affected, with reduced ankle plantar flexion and altered knee moments.
- PN group had higher compensatory values, suggesting neuropathy is the main cause of gait changes.

## Abstract

Gait compensatory mechanisms associated with partial foot amputation (PFA) and peripheral neuropathy (PN) aren’t well understood.

Current study aimed to assess deviations in the sagittal plane kinematics and moments of the lower limb joints in PFA due to PN versus PN alone.

Sagittal plane ROM and moment of the ankle, knee, and hip joints were measured for 53 participants assigned into two well-matched groups: (A) 25 subjects with healed unilateral PFA and (B) 28 subjects with PN peripheral neuropathy (PN). Gait analysis was conducted using a baropodometric system and STT 3DMA system.

MANOVA revealed that both groups had a similar pattern of sagittal ROM curves of lower limbs (p = 0.402). However, PFA group showed a reduction in ankle plantar flexion during the preswing (p = 0.005). Descriptive analysis of the moment curves revealed that both groups had similar compensatory patterns, specifically reduction in ankle plantar flexion moment and reversal of knee moment during late stance. However, PN group had higher values.

Individuals with either PFA due to PN or PN alone showed similar alterations in the sagittal plane kinematics and moments of the lower limb joints; they walked cautiously with excessive dorsiflexion throughout the stance phase, and the late stance phase was the most affected, while they compensated for the reduction in the ankle plantar moment by shifting the knee moment into extension moment. The results suggested that PN, not PFA, may be the primary cause of the gait alterations and PFA surgery only worsens the compensatory mechanisms.