Altered accelerator pedal control in a driving simulator in people with diabetic peripheral neuropathy

• Published in: Diabetic medicine 2020-02, Vol.37 (2), p.335-342
• Main Authors: Perazzolo, M., Reeves, N. D., Bowling, F. L., Boulton, A. J. M., Raffi, M., Marple‐Horvat, D. E.
• Format: Article
• Language: English
• Subjects: Age; Aged; Ankle; Ankle Joint - physiopathology; Automobile Driving; Case-Control Studies; Diabetes; Diabetes mellitus; Diabetes Mellitus - physiopathology; Diabetic Neuropathies - physiopathology; Female; Humans; Male; Medicare; Middle Aged; Muscle strength; Muscle Strength - physiology; Muscle Strength Dynamometer; Peripheral neuropathy; Proprioception; Proprioception - physiology; Research: Complications
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.13957

Aim To investigate whether the sensory‐motor impairment attributable to diabetic peripheral neuropathy would affect control of the accelerator pedal during a driving simulator task. Methods A total of 32 active drivers, 11 with diabetic peripheral neuropathy (mean ± sd age 67±5.0 years), 10 with diabetes but no neuropathy (diabetes group; mean ± sd age 62±10 years), and 11 healthy individuals without diabetes (healthy group; mean ± sd age 60±11 years), undertook a test on a dynamometer to assess ankle plantar flexor muscle strength and ankle joint proprioception function of the right leg, in addition to a driving simulator task. The following variables were measured: maximal ankle plantar flexor muscle strength; speed of strength generation (Nm/s); and ankle joint proprioception (ankle repositioning error, degrees). In the driving simulator task, driving speed (mph), accelerator pedal signal (degrees) and the duration of specific ‘loss‐of‐control events’ (s) were measured during two drives (Drive 1, Drive 2). Results Participants with diabetic peripheral neuropathy had a lower speed of strength generation (P