Citation

Sansosti LE, Spiess KE, Meyr AJ. J. Foot Ankle Surg. 2017; 56(3): 577-580.

Affiliation

Associate Professor, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA. Electronic address: ajmeyr@gmail.com.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1053/j.jfas.2017.01.044

PMID

28476389

Abstract

We have previously demonstrated an abnormally delayed mean brake response time and an increased frequency of abnormally delayed brake responses in a group of neuropathic diabetic drivers compared with a control group of drivers with neither diabetes nor lower extremity neuropathy. The objective of the present case-control study was to compare the mean brake response time between neuropathic diabetic drivers with and without specific diabetic foot pathology. The braking performances of the participants were evaluated using a computerized driving simulator with specific measurement of the mean brake response time and the frequency of abnormally delayed brake responses. We analyzed a control group of 20 active drivers with type 2 diabetes, lower extremity neuropathy, and no history of diabetic foot pathology and an experimental group of 20 active drivers with type 2 diabetes, lower extremity neuropathy, and a history of diabetic foot pathology (ulceration, amputation, and/or Charcot neuroarthropathy) from an urban U.S. podiatric medical clinic. Neuropathic diabetic drivers without a history of specific foot pathology demonstrated an 11.11% slower mean brake response time (0.790 ± 0.223 versus 0.711 ± 0.135 second; p < .001), with abnormally delayed reactions occurring at a similar frequency (58.13% versus 48.13%; p = .0927). Both groups demonstrated a mean brake response time slower than a suggested threshold of 0.70 second. The results of the present investigation provide evidence that diabetic patients across a spectrum of lower extremity sensorimotor neuropathy and foot pathology demonstrate abnormal automobile brake responses and might be at risk of impaired driving function.

Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Michigan neuropathy screening instrument; braking time; diabetes mellitus; diabetic peripheral neuropathy; driver's license; safe driving