Examination of gait and balance parameters in diabetic polyneuropathic individuals with lower extremity burn injury

This study was planned to evaluate the gait and balance parameters of individuals with lower extremity burn injury due to diabetic polyneuropathy (DPN). 14 subjects with DPN were included in the control group and 14 subjects with unilateral lower extremity burn injuries due to DPN in the study group. Demographic information, diabetes and DPN history, background, family history, etc. of the individuals participating in the study was recorded. In addition to this information, the etiology, localization and grade of burn injuries were recorded in the study group. Foot examination, lower extremity joint range of motion and muscle strength assessment applied to the individuals. Subjects were evaluated with Visual Analog Scale and Self-Leeds Assessment of Neuropathic Symptoms and Sign Scale for neuropathic pain, Semmes-Weinstein monofilament forsensory loss, Utah Early Neuropathy Scale for determination of the extent and severity of neuropathy, Romberg Test for static balance, Timed Up and Go Test for dynamic balance and GAITRite electronic walkway for spatio-temporal characteristics of gait. It was determined that the feet of the study group were colder, bruised and edematous, with all the range of motion of the ankle and the intrinsic muscle strength of the foot decreased, and the extent area and severity of DPN was higher than the control group (p<0.05). When the groups were compared, it was shown that the static and dynamic balance parameters were negatively affected in the study group (p<0.05). It was observed that the right and left step andstride lengths of the study group decreased, the double support percentage and the stance percentage increased on the burn side (p<0.05). These differences seen between the groups were thought that developed due to decreased sensation and motor loss in individuals with burn injuries with parallel to the extent and severity of DPN instead of burn injury. The inadequacy of gait and balance due to current sensory and motor loss reveals the factors that affect wound healing negatively. Therefore, our study reveals the importance of considering the inadequate load responses during the rehabilitation applications for individuals with burn injuries due to DPN. Key Words: Diabetic Polyneuropathy, Lower Extremity Burn Injury, Spatio-Temporal Parameters of Gait, Balance