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Accurate adjustments of the minimum toe clearance (MTC) height and step length can prevent older people from falling when walking and responding to hazards. Although older people with diabetes fall more frequently than healthy older adults, no previous studies have quantified their adaptive gait abilities. This study aimed to investigate the effects of diabetes mellitus on step length and MTC height\u00a0adjustments using a non-immersive virtual-reality system.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Sixteen young adults (26\u2009\u00b1\u20095\u00a0years, 7 females), 16 healthy older adults (68\u2009\u00b1\u20095\u00a0years, 6 females), and 16 older adults with diabetes (70\u2009\u00b1\u20095\u00a0years, 6 females) completed adaptability tests while walking on a treadmill. A computer system visualised a continuous real-time signal of absolute step length and MTC on a monitor. Each person responded to four discrete participant-specific step length and MTC visual targets that were presented on the same signal. Tasks were to match the peaks of interest on each signal to presented targets. Targets were 10% longer or shorter than the mean baseline step length, and 2.5\u00a0cm, and 3.5\u00a0cm higher than the mean baseline MTC. When a target was displayed, it remained unchanged for 10 consecutive foot displacement adaptation attempts. Then, the target was removed and a new target or the same target was present after 10 consecutive steps and remained for 10 steps. Each target was randomly presented three times (3\u2009\u00d7\u200910). Step length and MTC height adjustments in response to targets were measured and compared among groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Mean preferred walking speeds were not different among groups significantly when no targets were presented on the monitor in baseline walking. However, when participants walked on a treadmill while attempting to match step lengths or MTC heights to displayed targets on the monitor, the group with diabetes had reduced step length and MTC adjustments compared with other groups\u00a0significantly. They showed greater errors\u00a0(differences between their step lengths\/MTC heights and presented targets) on the monitor.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study quantified\u00a0reduced abilities\u00a0for older\u00a0individuals with diabetes to adjust both step length and MTC in response to stimuli\u00a0compared to healthy older\u00a0counterparts.\u00a0Reduced step length and MTC height\u00a0adjustments can increase falls in at risk populations. The presented virtual-reality system has merits for assessing and training step and MTC adaptation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12938-023-01082-2","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T09:32:06Z","timestamp":1683711126000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of diabetes mellitus on step length and minimum toe clearance adaptation"],"prefix":"10.1186","volume":"22","author":[{"given":"Suzanne","family":"Martin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon B.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blynn L.","family":"Shideler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajna","family":"Ogrin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rezaul","family":"Begg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,10]]},"reference":[{"issue":"3","key":"1082_CR1","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.jdiacomp.2005.06.004","volume":"20","author":"LM Tilling","year":"2006","unstructured":"Tilling LM, Darawil K, Britton M. 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