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J Exerc Rehabil. 2016 Dec 31;12(6):581-588. doi: 10.12965/jer.1632706.353. eCollection 2016 Dec.

Relationships among exercise capacity, dynamic balance and gait characteristics of Nigerian patients with type-2 diabetes: an indication for fall prevention.

Author information

1
Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
2
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus, Enugu, Nigeria.
3
Department of Physiotherapy, School of Medical Sciences, University of Benin, Benin City, Nigeria.
4
Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano, Nigeria.
5
Endocrinology and Metabolism Unit, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria; Department of Medicine, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

Abstract

This study investigated the relationships among exercise capacity (EC), dynamic balance (DB), and gait characteristics (GCs) of patients with type-2 diabetes (T2D) and healthy controls (HCs). This observational controlled study involved 125 patients with T2D receiving treatment at a Nigerian university teaching hospital and 125 apparently healthy patients' relatives and hospital staff recruited as controls. EC maximum oxygen consumption (VO2max) was estimated following a 6-min walk test. DB and GC were assessed using the Time Up to Go Test and an accelerometer (BTS G-Walk) assessing gait speed, step length, stride length, and cadence respectively during a self-selected walk. Data were analyzed using descriptive and inferential statistics. Alpha level was set at P<0.05. The mean ages of patients with T2D and HCs were 57.6±6.6 and 60.0±7.0 years, respectively. All physical characteristics were comparable (P>0.05). There were significant differences in the VO2max and DB between patients with T2D and HCs; 7.6±0.6 mL/kg/min vs. 9.6±0.6 mL/kg/min (t=-16.6, P=0.001) and 14.2±2.1 sec vs. 10.4±1.5 sec (t=-6.37, P=0.001), respectively. Furthermore, significant differences were found in GC between patients with T2D and HCs; gait speed: 0.7±0.1 m/sec vs. 1.2±0.1 m/sec (t=-16.60, P=0.001), step length: 0.6±0.2 m vs. 0.9±0.3 m (t=-7.56, P=0.001) and stride length: 0.9±0.1 m vs. 1.1±0.5 m (t=-6.09, P=0.001). There were significant correlations between EC and gait speed in both groups (T2D: r=-0.26, P=0.032 and HCs: r=0.51, P=0.003). In conclusion, patients with T2D demonstrated lower EC, unstable DB, and altered GCs compared with HCs. Exercise interventions to improve EC and gait balance are recommended.

KEYWORDS:

Exercise capacity; Fall prevention; Gait parameters; Stability; Type-2 diabetes

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