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Motor Learning in Gait in Subjects With Diabetic Peripheral Neuropathy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00223782
Recruitment Status : Completed
First Posted : September 22, 2005
Last Update Posted : March 24, 2008
Information provided by:
VA Office of Research and Development

Brief Summary:
The purpose of this study is to determine whether individuals with diabetic peripheral neuropathy can learn to change the way they walk in order to reduce the pressures underneath the feet, which may lead to a reduced risk of foot ulceration.

Condition or disease Intervention/treatment Phase
Diabetes Peripheral Neuropathy Behavioral: Gait Training with Feedback Behavioral: Gait Training with no feedback Not Applicable

Detailed Description:

This study suggests that teaching a new strategy is beneficial to decrease the forefoot peak plantar pressure in individuals who are susceptible to plantar ulcerations. It has not, however, been studied whether these changes would be maintained long-term or if they had any effect on the ulceration rate. Additionally, no analysis of the amount of visual feedback necessary to elicit the desired motor pattern was discussed. It has been suggested that proprioception plays an integral role in the use of feedback to develop error-detection mechanisms by integrating visual feedback and kinesthetic variables. In the diabetic peripheral neuropathy subject population, proprioception and kinesthesia may be compromised. This may have effects on the ability of this population to maintain changes in inappropriate movement patterns. A significant portion of patients continue to develop plantar ulcers even with prescriptive footwear compliance, so gait training to change inappropriate patterns which result in the high plantar pressures may be critical to prevent ulceration.

Comparisons: Two groups of subjects will receive gait training, one group will receive feedback of performance while the other will only receive training, and one control group. Comparisons will include whether plantar pressures are decreased in the training groups, and if those changes are maintained long-term.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 150 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Motor Learning in Gait in Subjects With Diabetic Peripheral Neuropathy
Study Start Date : May 2004
Actual Primary Completion Date : September 2006
Actual Study Completion Date : September 2006

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
1 Behavioral: Gait Training with Feedback
Behavioral: Gait Training with no feedback

Primary Outcome Measures :
  1. Plantar Pressure

Information from the National Library of Medicine

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Ages Eligible for Study:   50 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Diagnosis of diabetes for at least one year.
  2. Diabetic peripheral neuropathy as defined by failure to sense the 5.07 (10g) monofilament test in one or more of the six sites tested (31;32)
  3. Age 50-80 years old
  4. Able to ambulate independently without assistive devices (e.g. walker or crutches) (8) for 30 feet.
  5. No evidence of neurological (other than peripheral neuropathy) or orthopedic conditions

Exclusion Criteria:

  1. Other non-diabetic causes of neuropathy by history
  2. Symptomatic peripheral vascular disease
  3. Joint pain, swelling and/or limited of range of motion in the lower extremities that interfere with walking or exercise
  4. Visual problems not correctable with glasses or contact lens
  5. Passive range of motion limitations are described as:

    1. Hip flexion < 1000;
    2. Hip extension < 200;
    3. Knee flexion < 1250;
    4. Knee extension < 00 (unable to obtain full extension);
    5. Ankle plantar flexion < 250;
    6. Ankle dorsiflexion < 150
  6. Other systemic or local diseases that could interfere with walking assessment
  7. Severe systemic diseases other than diabetes or its complications, especially those interfering with exercise tolerance
  8. Amputation in the lower extremities
  9. Terminal illness
  10. Severe obesity: BMI>30 kg/m2 (33)
  11. Severe foot deformities (e.g. flexion contracture of the toes, pes cavus, Charcot disease)
  12. Mini-mental status of <27 or diagnosis of dementia
  13. History of alcohol or drug abuse

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00223782

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United States, California
VA Greater Los Angeles Healthcare System, West LA
West Los Angeles, California, United States, 90073
Sponsors and Collaborators
US Department of Veterans Affairs
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Principal Investigator: Karen Perell, PhD RKT VA Greater Los Angeles Healthcare System, West LA
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Responsible Party: Perell, Karen - Principal Investigator, Department of Veterans Affairs Identifier: NCT00223782    
Other Study ID Numbers: A3117R
First Posted: September 22, 2005    Key Record Dates
Last Update Posted: March 24, 2008
Last Verified: March 2008
Keywords provided by VA Office of Research and Development:
Peripheral Neuropathy
Additional relevant MeSH terms:
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Peripheral Nervous System Diseases
Neuromuscular Diseases
Nervous System Diseases