Role of muscle activity in diabetic neuropathic gait pattern: a study by dynamic simulation

Abstract

The literature has shown advances in the study of diabetic neuropathic gait, trying to describe kinetic, kinematic and electromyographic patterns as verify its relationship with plantar ulceration, although exploration of activation and strength of many muscles important for comprehension of the complex gait phenomenon still suffer experimental limitations and computational simulations can complement these experiments, allowing access to variables of difficult access. The aim of this study is to determine muscle activations, strength and role of lower limb muscles in the kinematic pattern adopted by diabetic neuropathic individuals with gait simulations through computational musculoskeletal model. Data from ground reaction force and hip, knee and ankle kinematics of 15 diabetic neuropathic and 15 healthy individuals will be used as input variables for the computational model in OpenSim software, which will enable to simulate the activation and strength of the iliopsoas, gluteus maximus, vastus lateralis, biceps femoris, rectus femoris, soleus, medial gastrocnemius, peroneus longus, tibialis anterior, plantar interossei, dorsal interossei, lumbrical and flexor hallucis longus muscles. EMG data of vastus lateralis, medial gastrocnemius and tibialis anterior muscles obtained experimentally from healthy and diabetic neuropathic individuals will be used to validate the muscle activation results of musculoskeletal model. It is expected to identify muscle strength patterns that compromised lead to kinematic consequences in diabetic neuropathic gait and then contribute to more effective therapeutic guidelines for this patient.