Background
Methods
Participants
CG (n = 10) | DG (n = 10) | DNG (n = 10) |
P-value | |
---|---|---|---|---|
Age (years) | 49.7 (4.7) | 54.5 (7.4) | 56.7 (7.3) | 0.096*
|
Sex (n° men) | 5 | 8 | 6 | 0.579†
|
Height (m) | 1.69 (0.07) | 1.68 (0.1) | 1.63 (0.11) | 0.295*
|
Body mass (kg) | 69.4 (7.8) | 75.1 (10.5) | 71.7 (11) | 0.462*
|
Body mass index (kg/m2) | 23.9 (2.2) | 26.0 (5.2) | 27.0 (3.4) | 0.163*
|
Diabetes duration (years) | -- | 5.8 (3.4) | 16.6 (6.2)‡
|
<0.001
*
|
MNSI-questionnaire (median) | -- | 2 | 8‡
|
0.001
*
|
Tactile perception#
| 0 | 0 | 6‡
|
0.003
†
|
Halux vibratory perception&
| 0 | 0 | 8‡
|
0.003
†
|
Data acquisition
Musculoskeletal model and muscle force estimation
Data Analysis
-
Hip flexors: psoas (40–60%), iliacus (40–60%);
-
Hip extensors: 3 portions of gluteus maximus (0–35%);
-
Hip abductors: 3 portions of gluteus medium (0–35% and 35–60%);
-
Hip extensors/knee-flexors: biceps femoris short head (40–60% and 80–100%), biceps femoris long head (40–60% and 80–100%), semitendinosus (40–60% and 80–100%), semimembranosus (40–60% and 80–100%);
-
Knee extensors: 4 portions of quadriceps femoris (vastus medialis, vastus intermedius, vastus lateralis, rectus femoris) (0–35%);
-
Ankle flexors: tibialis anterior (0–30% and 40–80%) and extensor hallucis longus (0–30% and 40–80%);
-
Ankle extensors: gastrocnemius medialis (30–50%), gastrocnemius lateralis (30–50%), soleus (30–50%), flexor hallucis longus (0–35% and 35–60%);
-
Ankle evertors: peroneus longus (0–35% and 35–60%), peroneus brevis (0–35% and 35–60%).
Results
Qualitative analysis
Quantitative analysis
Hip flexor and extensor muscles
Muscles (% Gait Cycle) | Force Peak (% BW) | ||||||
---|---|---|---|---|---|---|---|
CG1 (n=10) | DG2 (n=10) | DNG3 (n=12) | p Wilks’ Lambda*
| dCohen |
p
†
| ||
Hip Flexors | Psoas (40 – 60%) | 134.5 ±36.8a
| 140.7 ±26.0b
| 156.1 ±30.6a,b
| 0.129*
| __ | __ |
Iliacus (40 – 60%) | 120.1 ±32.0 | 124.6 ±24.2 | 138.7 ±29.8 | __ | __ | ||
Hip Extensors | Gluteus Maximus– external portion (0 – 35%) | 16.9 ±3.6 | 16.3 ± 1.8 | 16.3 ±4.61 | 0.669*
| __ | __ |
Gluteus Maximus– intermediate portion (0 – 35%) | 24.8 ±8.2 | 23.1 ±6.6 | 22.1 ±7.9 | __ | __ | ||
Gluteus Maximus– internal portion (0 – 35%) | 4.6 ±5.9 | 5.2 ±3.4 | 3.79 ±5.5 | __ | __ | ||
Hip Abductors | Gluteus Medium– anterior portion (0 – 35%) | 63.5 ±12.5 | 61.6 ±8.7 | 59.6 ±15.1 |
0.001
*
| (1x2) -0.176 (1x3) -0.281 (2x3) -0.162 | 0.335†
|
Gluteus Medium– anterior portion (35 – 60%) | 64.5 ±15.9a,b
| 51.7 ±18.5a
| 53.0 ±21.8b
| (1x2) -0.742 (1x3) -0.603 (2x3) 0.064 |
0.028
†
| ||
Gluteus Medium– middle portion (0 – 35%) | 41.3 ±8.1a
| 34.8 ±4.2a,b
| 39.6 ±9.7b
| (1x2) -1.007 (1x3) -0.190 (2x3) 0.642 |
0.005
†
| ||
Gluteus Medium– middle portion (35 – 60%) | 40.9 ± 7.2a
| 34.7 ±5.9a,b
| 41.7 ±7.4b
| (1x2) -0.942 (1x3) 0.110 (2x3) 1.046 |
0.013
†
| ||
Gluteus Medium– posterior portion (0 – 35%) | 45.1 ±9.2a
| 37.6 ±6.0a,b
| 42.3 ±12.5b
| (1x2) -0.966 (1x3) -0.255 (2x3) 0.479 |
0.003
†
| ||
Gluteus Medium– posterior portion (35 – 60%) | 38.7 ±8.4 | 33.8 ±8.6a
| 47.9 ±11.8a
| (1x2) -0.576 (1x3) 0.898 (2x3) 1.366 |
0.012
†
|
Hip abductor muscles
Hip extensor- knee flexor muscles
Muscles (% Gait Cycle) | Force Peak (% BW) | ||||||
---|---|---|---|---|---|---|---|
CG1 (n=10) | DG2 (n=10) | DNG3 (n=12) | p Wilks’ Lambda*
| dCohen |
p
†
| ||
Hip Extensors- Knee Flexors | Biceps Fem. Short Head (40 – 60%) | 51.1 ±15.5a
| 57.8 ±18.7b
| 80.4 ±25.5a,b
|
<0.001
*
| (1x2) 0.390 (1x3) 1.389 (2x3) 1.011 |
<0.001
†
|
Biceps Fem. Short Head (80 – 100%) | 32.0 ±12.6a
| 19.6 ±8.3a
| 27.3 ±5.6 a
| (1x2) 1.162 (1x3) 0.482 (2x3) 1.088 |
<0.001
†
| ||
Biceps Fem. Long Head (40 – 60%) | 0.3 ±0.8 | 0.7 ±2.5 | 3.45±9.0 | (1x2) 0.216 (1x3) 0.493 (2x3) 0.416 | 0.072†
| ||
Biceps Fem. Long Head (80 – 100%) | 20.4 ±6.1 | 15.6 ±5.6 | 15.1 ±11.3 | (1x2) -0.820 (1x3) -0.584 (2x3) -0.056 | 0.060†
| ||
Semitendinosus (40 – 60%) | 1.42 ±2.4a
| 0.17±0.5b
| 6.1 ±8.2a,b
| (1x2) -0.721 (1x3) 0.775 (2x3)1.021 |
<0.001
†
| ||
Semitendinosus (80 – 100%) | 5.6 ±1.9a
| 4.3 ±1.5a,b
| 6.0 ±1.6b
| (1x2) -0.759 (1x3) 0.228 (2x3) 1.096 |
<0.001
†
| ||
Semimembranosus (40 – 60%) | 6.4±10.0a
| 7.2±12.1b
| 29.4±31.3a,b
| (1x2) 0.072 (1x3) 0.990 (2x3) 0.936 |
<0.001
†
| ||
Semimembranosus (80 – 100%) | 62.0 ±13.6a
| 45.1 ±13.7a,b
| 68.5 ±9.7b
| (1x2) 1.238 (1x3) 0.550 (2x3) 1.971 |
<0.001
†
| ||
Knee Extensors | Vastus Lateralis (0 – 35%) | 13.8 ±11.9a
| 29.7 ±21.5a,b
| 19.0 ±19.7b
|
0.034
*
| (1x2) 0.915 (1x3) 0.320 (2x3) -0.519 |
0.004
†
|
Vastus Intermedius (0 – 35%) | 8.8 ± 7.8 | 17.8 ±13.2 | 11.8 ±11.7 | (1x2) 0.830 (1x3) 0.302 (2x3) -0.481 | 0.293†
| ||
Vastus Medialis (0 – 35%) | 6.6 ± 5.5a
| 13.44 ±9.3a,b
| 8.7 ±9.0b
| (1x2) 0.895 (1x3) 0.282 (2x3) -0.518 |
0.004
†
| ||
Rectus Femoris (0 – 35%) | 44.5 ± 17.7 | 51.93 ±21.5 | 52.9 ±22.1 | (1x2) 0.377 (1x3) 0.420 (2x3) 0.044 | 0.941†
|
Knee extensor muscles
Ankle flexor muscles
Muscles (% Gait Cycle) | Force Peak (% BW) | ||||||
---|---|---|---|---|---|---|---|
CG1 (n=10) | DG2 (n=10) | DNG3 (n=12) | p Wilks’ Lambda*
| dCohen |
p
†
| ||
Ankle Flexors | Tibialis Anterior (0 – 30%) | 58.5±16.5 | 62.7±27.4 | 66.6±23.4 | 0.059 | __ | __ |
Tibialis Anterior (40 – 80%) | 10.2 ±1.5 | 11.9 ±6.1 | 9.1 ±1.1 | __ | __ | ||
Ankle Extensors | Gastrocnemius Medialis (30– 50%) | 173.6 ±29.3 | 183.0 ±30.5a
| 158.7 ±37.6a
|
<0.001
*
| (1x2) 0.314 (1x3) -0.442 (2x3) -0.710 |
0.037
†
|
Gastrocnemius Lateralis (30 – 50%) | 38.0 ±8.6a
| 42.7 ±15.6b
| 44.8 ±17.7a,b
| (1x2) 0.373 (1x3) 0.489 (2x3) 0.126 |
0.021
†
| ||
Soleus (0 – 30%) | 35.2 ±37.3 | 37.1 ±31.1 | 29.0 ±26.2 | (1x2) 0.055 (1x3) -0.192 (2x3) -0.282 | 0.666†
| ||
Soleus (40 – 60%) | 213.0 ±39.9a
| 183.1 ±29.3a
| 195.8 ±48.2 | (1x2) -0.854 (1x3) -0.389 (2x3) 0.318 |
0.024
†
| ||
Ankle Evertors | Peroneus Longus (0 – 35%) | 11.9 ±8.3a
| 26.6 ±18.4a,b
| 17.3 ±12.4b
|
<0.001
*
| (1x2) 1.030 (1x3) 0.512 (2x3) -0.593 |
<0.001
†
|
Peroneus Longus (35 – 60%) | 25.1 ±19.5a
| 31.5 ±19.1b
| 64.2 ±35.9a,b
| (1x2) 0.332 (1x3) 1.353 (2x3) 1.137 |
<0.001
†
| ||
Peroneus Brevis (0 – 35%) | 4.0 ±2.6a
| 7.9 ±5.4a,b
| 5.3 ±3.5b
| (1x2) 0.920 (1x3) 0.422 (2x3) -0.571 |
0.003
†
| ||
Peroneus Brevis (35 – 60%) | 4.9 ±3.5a
| 7.2 ±4.6b
| 12.4 ±7.8a,b
| (1x2) 0.563 (1x3) 1.241 (2x3) 0.812 |
<0.001
†
|