Faster walking speeds increase local instability among people with peripheral neuropathy

Individuals with peripheral neuropathy (PN) may compensate for decreased somatosensation by reducing walking speed. Predisposition to falls may therefore arise from an inability to adapt to challenging walking speeds. The purpose of this study was to examine the effects of PN on the magnitude of variability and local instability on walking at different speeds. Twelve individuals with PN and 12 controls completed a 6-min walk test to determine fast walking speed (FWS). Sagittal plane hip, knee, and ankle joint angles were then calculated during 3 min of treadmill walking at 100%, 80%, and 60% FWS. The magnitudes of stride duration variability (SDvar), joint angle variability (JTvar), and both short- and long-term Lyapunov exponents (used to estimate local instability) were calculated. The PN group walked slower than the control group (p<.001). With groups combined, walking faster led to increased local instability and increased variability (p<.001). The PN group exhibited increased variability (SDvar, p=.02; JTvar, p=.01) over all speeds, and exaggerated local instability (p<.05) when walking at the fastest speed. PN leads to increased walking variability and local instability, particularly when walking at challenging speeds. These results are important to consider in future patient education and rehabilitation programs.