Effect of Multifactorial Balance Rehabilitation Program on Risk of Falls and Functional Fitness in Older Adults with Diabetic Peripheral Neuropathy

Abstract

Background: Increasing age and the added disadvantage of diabetic peripheral neuropathy (DPN) put the individual at a higher risk of falls and reduced functional fitness. However, there is a dearth of literature on multifactorial balance intervention, especially targeting the needs of older adults with DPN. Objective: The current study aimed to determine the effect of a multifactorial balance rehabilitation program on fall risk and functional fitness in older adults with DPN. Method: In this pre-post experimental study, 30 independently ambulating older adults (71.2 ± 4.70 years) with DPN, who were at risk of falling (timed up and go score ≥ 9.4 seconds), were recruited. Along with the standard care, all the participants received 12 weeks of the multifactorial balance rehabilitation program. Results: Fall risk using the Fullerton Advanced Balance scale and functional fitness using the Senior Fitness Test were measured at baseline and after 12 weeks of the intervention. The intervention reduced the risk of falling score significantly (MD= 6.17, p< .001). All six parameters of functional fitness improved after 12 weeks of intervention. The improvement in lower limb strength (MD=1.53 times), upper limb strength (MD=2.48 times), endurance (MD= 16.07 seconds), lower limb flexibility (MD= 2.02 inches), upper limb flexibility (MD= 1.47 inches), and dynamic balance (MD= 1.53 seconds) was statistically significant at p< 0.05. Conclusion: This study provided encouraging evidence about the potential of multifactorial balance rehabilitation to reduce the risk of falling and improve functional fitness in older adults with DPN. other: NA

When, where, and why should we look for vestibular dysfunction in people with diabetes mellitus?

“…Simple oculomotor tests (i.e., pursuit, gaze, VOR cancellation, optokinetic response), DVA testing, and static and dynamic balance tests that require an integrated vestibular response are reasonable to include during patient evaluations. We expect such an approach will allow clinicians to add vestibular exercises and based movements, as indicated, to current approaches aimed at improving balance in people with DM ( 68 , 69 ). Finally, in cases where individuals do not respond to this type of an approach, use of vestibular diagnostic testing may be of some benefit.…”