# Walking Function in Individuals with Diabetic Peripheral Neuropathy: Biomechanical Mechanisms and Implications for Clinical Outcomes and Gait Retraining

> **NIH NIH K01** · EMORY UNIVERSITY · 2022 · $131,085

## Abstract

PROJECT SUMMARY/ABSTRACT
Over 34 million adults in the United States (~1 in 10) are living with Diabetes Mellitus (DM). Diabetic peripheral
neuropathy (DPN) is the most common complication, affecting more than 50% of individuals with DM. People
with DPN display marked reductions in quality of life (QoL) and functional mobility. Consequences of DPN
include reduced sensation and feedback from the foot and lower limb and increased plantar pressures,
predisposing patients to ulcers and lower extremity amputation. We predict that persons with DPN who show
reduced functional mobility and walking speed, will have an associated reduction in propulsion during gait. Our
rationale for this work is that plantar pressure and propulsion are two key inter-related gait parameters that
contribute to ulceration, amputation risk, and reduced walking function in people with DPN, adversely
impacting QOL. Traditional gait training programs used to improve walking function may increase ulceration
risk, making these interventions unsuitable if not tailored for people with DPN. The goal of this proposal is to
elucidate the underlying biomechanical mechanisms contributing to the inter-relationships between plantar
pressure and propulsion in individuals with DPN, and to examine the safety and feasibility of using real-time
biofeedback to modify plantar pressure and propulsion during gait. To meet this goal, we propose to perform a
comprehensive biomechanical analysis including measurements of plantar pressure and propulsion, as well as
ankle kinematics, kinetics, and joint stiffness during walking. We will use plantar pressure and propulsion
biofeedback during walking as a probe to illuminate underlying biomechanical mechanisms of walking
dysfunction in people with DPN, while evaluating the individual-specific optimum dosage of biofeedback to
reduce plantar pressure while maintaining or enhancing propulsion. Additionally, we will conduct a preliminary
clinical trial to examine the feasibility and safety of using individualized real-time gait biofeedback as a gait
training method in individuals with DPN. The aims of this research plan proposal are to evaluate (1)
biomechanical mechanisms contributing to abnormal plantar pressure and propulsion during gait in individuals
with DPN; (2) biofeedback-induced changes in plantar pressure, propulsion, and biomechanics during gait in
individuals with DPN and age-similar controls; and (3) the acceptability, feasibility, safety, and preliminary
effects of gait training in individuals with DPN. Insights into the biomechanical mechanisms underlying plantar
pressure and propulsion in people with DPN will allow us to design more informed and effective gait
rehabilitation interventions aimed at preventing deleterious outcomes such as ulceration and amputation that
can be tailored to individual patient characteristics. The K01 training plan will prepare the PI with training in the
clinical disease processes of DM, mechanisms underlying gait...

## Key facts

- **NIH application ID:** 10525968
- **Project number:** 1K01HD107294-01A1
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Nicole Kristen Rendos
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $131,085
- **Award type:** 1
- **Project period:** 2022-09-01 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10525968

## Citation

> US National Institutes of Health, RePORTER application 10525968, Walking Function in Individuals with Diabetic Peripheral Neuropathy: Biomechanical Mechanisms and Implications for Clinical Outcomes and Gait Retraining (1K01HD107294-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10525968. Licensed CC0.

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