Why are patients with diabetic peripheral neuropathy more likely to fall? An examination of the underpinning biomechanical mechanisms of locomotion and the influence of intervention.

The research for this thesis examined the effects of diabetic peripheral neuropathy (DPN) on biomechanical factors related to the risk of falling during locomotor tasks, and the effects of a 16-week multi-factorial intervention on the identified impairments. The speed of ankle and knee strength generation, and muscular activations were measured during stair ascent and descent; and minimum toe clearance, stepping accuracy, and visual gaze parameters were measured during level ground walking. Patients with DPN, diabetes patients with no neuropathy and non-diabetic controls were measured before and after a 16-week intervention consisting of high-load resistance exercises and a visual gaze training task. Patients with DPN displayed slower ankle and knee strength generation during stair ascent and descent than healthy controls (p