Onset and cessation timing of seven lower limb muscles during walking in patients with diabetes with and without sensory neuropathy and persons without diabetes

Background and aim. The aim of this study was to investigate the differences in onset and cessation timing of seven lower limb muscles during gait of participants with diabetes, with (PwDM_SNP) or without (PwDM) sensory neuropathy and asymptomatic adults (PwNoDM). Methods. Surface EMG recordings of rectus femoris, vastus lateralis, medial hamstrings, tibialis anterior, peroneus longus, soleus and lateral gastrocnemius of the three experimental groups were taken while walking at a self-selected speed. Each group consisted of thirteen age-, sex- and speed matched subjects. Onset and cessation timing for each participant and each muscle was determined through the application of the automated method described by Staude et al (2001). One-way ANOVA was applied to investigate differences between the three groups. Results. Both diabetes groups showed changes in muscle activation compared to the persons without diabetes, although not always significant. There were no significant differences in onset timing between the three groups. Cessation timing of the rectus femoris was significantly later in PwDM_SNP compared to PwDM and PwNoDM (table 1). Also cessation of the tibialis anterior was delayed in PwDM_SNP group compared to PwDM (p=0.02) and PwNoDM (not significant). The peroneus longus on the other hand, showed a significant earlier cessation time in PwDM_SNP and PwDM compared to PwNoDM. Conclusions. Diabetes patients with and without sensory neuropathy demonstrate altered activation pattern of lower limb muscles during walking.