Date of Award

12-30-2021

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Systems Engineering

First Advisor

Kamran Iqbal

Abstract

BACKGROUND: Diabetic peripheral neuropathy (DPN) is a very common disease most prevalent in people with type-II diabetes. DPN is caused by high blood glucose levels that instigates nerve damage which results in sensation loss mainly in the lower extremities. RESEARCH OBJECTIVE: The objective of this study is to explore into the motor disability resulting from DPN disorder by investigating into the muscle activation patterns, force output in lower extremity muscles, the onset of muscle fatigue and most importantly evaluating the postural stability in DPN patients and comparing the results to healthy control subjects. We hypothesize that the DPN patients suffer from muscle weakness due to nerve damage and hence demonstrate abnormal muscular contractions and force output in lower extremity muscles due to which DPN patients are more prone to falls. METHODOLOGY: A total of 30 participants participated in this study. Fifteen were patients with DPN disorder and the other fifteen were age and gender matched healthy control volunteers. A 3D motion capture system (Vicon Nexus) was used to record the kinematics data while four force plates were embedded in the ground to record the ground reaction forces. EMG data was collected from 9 lower extremity muscles to analyze muscular contractions, neuromusculoskeletal modelling and for the detection of the onset of muscle fatigue in DPN patients. Time to boundary (TTB) calculations were performed to assess postural stability. The time to failure during tandem balance stance was our measure for assessing static balance control in DPN patients. The time to complete the time up and go (TUG) trial was our measure for testing balance, mobility, and strength in DPN patients. SGNIFICANCE: Balance impairment is a common problem in patients with DPN. DPN could lead to postural balance deficits and potentially impose a gigantic risk of falls in patients with DPN as compared to people without DPN. Furthermore, several studies have reported that patients with DPN showed sensorimotor deficits which are associated with postural and gait instability. Thus, characterizing postural stability and elucidating causes behind reduced balance ability in this important patient population gains significant importance.

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