Peripheral neuropathy does not alter the fractal dynamics of stride intervals of gait

The purpose of this study was to determine the effect (if any) of significant sensory loss on the long-range correlations normally observed in the stride intervals of human gait. Fourteen patients with severe peripheral neuropathy and 12 gender-, age-, height-, and weight-matched nondiabetic controls participated. Subjects walked around an ∼200-m open-level walkway for 10 min at their comfortable pace. Continuous knee joint kinematics were recorded and used to calculate a stride interval time series for each subject. Power spectral density and detrended fluctuation analyses were used to determine whether these stride intervals exhibited long-range correlations. If the loss of long-range correlations indicates deterioration of the central control of gait, then changes in peripheral sensation should have no effect. If instead the loss of long-range correlations is a consequence of a general inability to regulate gait cycle timing, then a similar loss should occur in patients with peripheral locomotor disorders. Both power spectral density analyses and detrended fluctuation analyses showed that temporal correlations in the stride times of neuropathic and control subjects were statistically identical (P = 0.954 and P = 0.974, respectively), despite slower gait speeds (P = 0.008) and increased stride time variability (P = 0.036) among the neuropathy patients. All subjects in both groups exhibited long-range correlations. These findings demonstrate that the normal long-range correlation structure of stride intervals is unaltered by significant peripheral sensory loss. This further supports the hypothesis that the central nervous system is involved in the regulation of long-range correlations.