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Advanced Neurology

ORIGINAL RESEARCH ARTICLE
Impact of foot sole insensitivity and reduced

nerve conduction velocity on postural control
and functional gait

2
1
Kelsey Lewis , Menzi Sun , Barry Joyner , Barr Munkasy , and Li Li *
1
1
1
1 Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, Georgia,
United States of America
2 Biomechanics Laboratory, Beijing Sport University, Beijing, China

Abstract

Peripheral neuropathy is characterized by decreased foot sole sensitivity and slowed
nerve conduction velocity, leading to impaired postural control and functional gait
performance. This study assessed the differential effects of reduced foot sole sensitivity
and slowed nerve conduction velocity on postural control and functional gait. Thirty-
five participants were evaluated for two main clinical symptoms: the H-index and
foot sole sensitivity. Two times the square of the height (H) of the individual divided
by the latency (T) between the onsets of the M- and H-waves of the H-reflex were
used to calculate the H-index (2 × [H/T] ). Foot sole sensitivity was evaluated using a
2
monofilament on five sites at the bottom of the foot. Participants were categorized
into three symptomological groups: (i) less affected (LA), (ii) moderately affected (MA),
and (iii) severely affected (SA), based on their H-index ranges of 78.0 – 109.4, 42.8 –
76.6, and 45.6 – 75.5 cm /ms , respectively, and foot sole sensitivity score ranges of
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2
*Corresponding author:
Li Li 6 – 10, 6 – 10, and 0 – 5, respectively. Outcome variables included center of pressure
(lili@georgiasouthern.edu) (COP) standard deviation in the anteroposterior direction and COP average velocity
(V ) during 30 s of eyes-open quiet standing, as well as 6-min walk distance (6MWD)
Citation: Lewis K, Sun M, Joyner B, avg
Munkasy B, Li L. Impact of foot sole and timed-up-and-go duration (TUG). Multivariate analysis revealed significant
insensitivity and reduced nerve group differences (P < 0.05), with post hoc analysis showing significant differences
conduction velocity on postural between LA and SA in V (F = 3.752; P = 0.014). Discriminant analysis revealed
control and functional gait. Adv avg 4,30
Neuro. 2024;3(2):2900. V as the primary determinant, while 6MWD and TUG were secondary determinants
avg
doi: 10.36922/an.2900 of group separation. Notably, enhanced functional gait was associated solely with
Received: February 7, 2024 sensitive foot soles and heightened nerve conduction velocity within the LA group,
not in the MA or SA groups. Disease severity mediated the specific effects on postural
Accepted: March 29, 2024
control and functional gait, underscoring the importance of tailoring rehabilitation
Published Online: June 5, 2024 protocols to address individual symptoms.
Copyright: © 2024 Author(s).
This is an Open-Access article
distributed under the terms of the Keywords: Diabetes; Neuropathy; Neurodegenerative diseases; Biomechanics; Gait
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited. 1. Introduction
Publisher’s Note: AccScience Peripheral neuropathy (PN) is a degenerative disease that mainly affects the peripheral
Publishing remains neutral with sensory nerves. The common causes of PN include diabetes mellitus, the human
1,2
regard to jurisdictional claims in 3
published maps and institutional immunodeficiency virus, or chemotherapy. This condition impacts millions of
affiliations individuals, manifesting in positive symptoms (e.g., burning, tingling, allodynia, and

Volume 3 Issue 2 (2024) 1 doi: 10.36922/an.2900