F WAVE ANALYSIS IN DIABETIC POLYNEUROPATHY
M. Toyokura (Tokai University, School of Medicine, Isehara, Japan)
F wave measurement has been recommended in addition to conventional motor and sensory nerve conduction studies (NCS) to detect diabetic polyneuropathy. In this study diagnostic sensitivity of various F wave parameters in diabetic polyneuropathy were analyzed.
Fifty-one patients (mean age, 48) participated in the study. Polyneuropathy was diagnosed from findings of clinical measures (symptoms, neurological examinations and vibration perception test) and conventional motor and sensory NCS. F waves were obtained by stimulation of the ulnar, tibial, and peroneal nerves at the wrist or ankle. The F wave parameters used were minimum latency (Fmin), maximum latency (Fmax), mean latency (Fmean), chronodispersion (Fdif), mean duration (Fdur), mean amplitude (ramp), and mean area (Farea). Ttle latency values (Fmin, Fmax, and Fmean) were corrected for height (the values (ms) / height (m)).
In conclusion F wave latencies (Fmin, Fmax, and Fmean) were the most sensitive. Some patients had abnormal Fdur or Fdif with no latency prolongation. These two parameters provided additional useful information, whereas Famp and Farea were of little value in the diagnosis of diabetic polyneuropathy.
AN AUGMENTED AUDITORY FEEDBACK FOOTWEAR: A GAIT TRAINING DEVICE FOR DIABETIC PATIENTS
Bee Giok K.Tan (UNIVERSITY OF SANTO TOMAS, MANILA PHILIPPINES), RC DY, K. HABANA, CJ WONG, JEM ADRIATICO, RJ BARETTO
Sensory and proprioceptive deficits account largely for the gait deviations and reported incidence of falls and injuries among patients afflicted with long standing diabetes mellitus. This study aims to develop and test an augmented auditory feedback footwear to improve the gait pattern and rehabilitation outcome of proprioceptive deficient diabetics. A diabetic foot-friendly sandal (DFFS) with whistle pins that provides auditory feedback during ambulation was developed and tested. Comparative studies were done between 7 randomly selected normal control and 6 male diabetic subjects referred by endocfinologists and who satisfied the selection criteria. Gait pattern while walking on the Quinton Q55-TM treadmill was video recorded and analyzed biomechanieally using the peak performance 2-dimensional motion analysis system-TM Pre-test and post-test analysis were conducted 3 wks apart. Subjects were allowed to train with DFFS in between testing period. Variables measured were analyzed statistically using the non- parametric McNemar's and Wilcoxon Sign Rank tests, with P<0.05 considered significant. Comparison and analysis of angular values show that diabetics have decreased trunk angles at toe off and increased ankle angles at heel strike compared to normal subject while gait pattern of the study group improved to near normal values after training with the DFFS. Step and stride length of the study population also showed significant increase with p-value of P<0.03. Patient's subjective evaluation of DFFS using the likart scale revealed a high level of satisfaction. The training with DFFS showed functional carry-over as gait pattern correction, increased voluntary muscle action and improved functional independence despite the existing sensory perceptual deficit.