Effects of Multisensory Training on Balance and Gait in Persons with Type
                        2 Diabetes: A Randomised Controlled Trial

Kutty, Nizar Abdul Majeed; Majida, Nishad Abdul Latheef

doi:10.5463/dcid.v24i2.206

Cited by 14 publications

(7 citation statements)

References 31 publications

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“…The inclusion criteria were as follows: 1) type II diabetes with a minimum duration of 5 years (11), 2) Fasting Blood Sugar (FBS( ≥7 mmol/l or 126 mg/dl (19),3) Glycated hemoglobin (HbA1c) between 7% and 9% (26), 4) Body Mass Index (BMI) between 25 and 29/9 kg/m 2 (27), 5) neuropathy diagnosed by a score higher than 2 out of the first part and higher than 1 out of the second part in the Michigan Neuropathy Screening Instrument (MNSI) (25) and score between 10-18 in the Valk questionnaire (28),6) ability to ambulate at least 10 meters without an assistive device (29), 7) strength of ankle dorsal/plantar flexors, invertors/evertors ≥ 3 by manual muscle testing (29), 8) at least 20/40 score in snellen dominant eye test chart (26),9) lack of foot and ankle ulcers at the time of the study (21), 10) lack of lower extremity sever pain at the time of the study (21), and 11) lack of regular physical training and physiotherapy intervention in the last three months (30). On the other hand, the exclusion criteria entailed: 1) lower extremity fractures and dislocation, 2) surgery or lower extremity amputation, 3) foot ulcers at study time, 4) cardiac autonomic neuropathy, 5) non-diabetic neuropathy, 6) vestibular system disorders, 7) internal ear infections, and 8) other balance disorders (30). Since condition 2 was assessed in the head hyperextension position, the vertebral artery involvement test was performed for all participants, and they were excluded if the results were positive.…”

Section: Methodsmentioning

confidence: 99%

Dynamic balance and neuropathic changes following ankle proprioceptive training in type II diabetic patients with peripheral neuropathy

Ravand

Ghasemi

Rahimi

et al. 2021

ircmj

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Introduction: Peripheral neuropathy is one of the major complications of type II diabetes mellitus. Lower limb proprioceptive impairments due to neuropathy can lead to balance disorders in these patients. The present study aimed to investigate postural stability and neuropathic changes following ankle proprioceptive training in type II diabetic patients with moderate neuropathy. Materials and Methods: The present study was conducted on 24 type II diabetic patients with moderate neuropathy (9 females and 15 males) aged 40-65 years (with a mean age of 57.25 years). The treatment consisted of ankle proprioceptive training by the balance board and rocker for 10 consecutive days. Balance indices, including Overall Stability Index (OSI), Anterior-Posterior Stability Index (APSI), and Medial-Lateral Stability Index (MLSI), were measured with Biodex system before and after the treatment, as well as two weeks after treatment in two conditions: condition1: Eyes open, head straight, without using trunk, pelvis, thigh, and knee constrained orthosis. Condition 2: Eyes closed, head back (hyperextension), with using trunk, pelvis, thigh, and knee constrained orthosis. Plate-based Biodex stability was fixed at levels 6 and 8 for condition1 and level 8 for condition 2. The severity of neuropathy was assessed using Valk and Michigan questionnaires, as well as light touch sensation. The analysis of variance with repeated measure was used to evaluate alterations in the stability of patients. Furthermore, the correlation of neuropathic changes and stability parameters were assessed by the Pearson correlation coefficients. Results: Significant improvements were observed in OSI in all tests of condition 1 (Biodex Balance System (BBS) at level 8 (P=0.001) and level 6 (P=0.017), as well as test conditions 2 (level 8; P=0.004). After the treatment, at stability level 8, a significant improvement in the mean values of postural sways in the Anterior-Posterior (AP) direction demonstrated that the ankle strategy was improved in the patients. After the treatment, the scores of the Valk (P=0.02) and Michigan (P=0.001) questionnaires were significantly decreased. After two weeks of follow-up, the observed improvement was maintained in the mean values of balance indices (OSI, APSI) and neuropathy due to treatment. Conclusion: As evidenced by the obtained results, 10 sessions of targeted ankle proprioceptive training improved stability, neuropathy, and light touch sensation of the foot in type II diabetic patients with moderate neuropathy. Foot somatosensory information is one of the most important causes of balance alterations in these patients

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Section: Methodsmentioning

confidence: 99%

Dynamic balance and neuropathic changes following ankle proprioceptive training in type II diabetic patients with peripheral neuropathy

Ravand

Ghasemi

Rahimi

et al. 2021

ircmj

View full text Add to dashboard Cite

show abstract

“…Two studies collected and reported information about multisensory exercise, which included participants all females [31,32] . Of these participants, 30 were ataxic patients [33] , 73 were older adults with a history of falls [20,34,35] , 33 were older adults without fall history [35,36] , 18 were older adults with visual impairment [37] , 16 were diabetics with peripheral neuropathy [38] , and 21 were patients with essential tremor [39] . A total of 667 participants were included in the 20 studies, four studies were conducted in the United States, four in Canada, two in Brazil, and two in France, other studies in England, Indian, Sweden, and so on.…”

Section: Participants and Settingsmentioning

confidence: 99%

“…The total time spent in exercising during the multisensory exercise interventions varied from 0.5 [30,40] to 180 h [33] , while the intervention duration ranged from 2 [41] to 16 weeks [31] . Studies of intervention time showed that multisensory exercises worked within 6 weeks [34,38,42] , 8 weeks [20,39,43] , 12 weeks [36,37,44] ) respectively. However, there are still studies which reported effective intervention duration was less than 6 weeks or more than 12 weeks.…”

Section: Intervention Programsmentioning

confidence: 99%

Multisensory Exercise Improves Balance in People with Balance Disorders: A Systematic Review

Zhang

Liú

et al. 2021

CURR MED SCI

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Objective To examine the effect of multisensory exercise on balance disorders. Methods PubMed, Scopus and Web of Science were searched to identify eligible studies published before January 1, 2020. Eligible studies included randomized control trials (RCTs), non-randomized studies, case-control studies, and cohort studies. The methodological quality of the included studies was evaluated using JBI Critical Appraisal Checklists for RCTs and for Quasi-Experimental Studies by two researchers independently. A narrative synthesis of intervention characteristics and health-related outcomes was performed. Results A total of 11 non-randomized studies and 9 RCTs were eligible, including 667 participants. The results supported our assumption that multisensory exercise improved balance in people with balance disorders. All of the 20 studies were believed to be of high or moderate quality. Conclusion Our study confirmed that multisensory exercise was effective in improving balance in people with balance disorders. Multisensory exercises could lower the risk of fall and enhance confidence level to improve the quality of life. Further research is needed to investigate the optimal strategy of multisensory exercises and explore the underlying neural and molecular mechanisms of balance improvement brought by multisensory exercises.

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“…These individuals walk 20-30% slower on par with the age matched healthy individuals. [13] The gait alterations include reduced cadence, decreased gait velocity, shorter stride length, increased stance time. Uneven surfaces are more challenging for these patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Exercises on two Unstable Surfaces for Balance and Gait Reeducation in Patients with Diabetic Peripheral Neuropathy

Maruboyina¹

2018

jmscr

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Background and Purpose: The incidence of diabetes is increasing rapidly in India, so as the complications are. The most significant complication is peripheral neuropathy which leads to weakness of muscles and lack of protective sensation in the foot because of demyelination of sensory and motor nerves. In this context patient will lose balance, feel difficulty while walking and may fall. So balance and gait reeducation plays a vital role to improve functional ability, postural control and to reduce falls. Till date many studies have been done to improve balance by using unstable surfaces. Comparison of two unstable surfaces is still lacking. So this study is intended to know whether wobble board is best or stability disc to improve balance in diabetic individuals. Materials and Methods: 30 participants with diabetic neuropathy were randomly assigned into two groups; group A (n=15) underwent exercises on wobble board and group B(n=15) received exercises on stability disc for 30 min for 8 weeks. Pre and post intervention balance was assessed by Berg balance sale and gait was assessed by TUG. Results: Results of Berg Balance Scale were analysed using non parametric tests and TUG scores were analysed using t tests. The observed differences of values were tested with the Z at 95% level of significance (p<0.05). Conclusion: Both groups have showed good upshots in recovery after the study. The subjects who were trained on stability disc showed substantial improvement when compared to subjects trained on wobble board (p<0.05). Hence we conclude that stability disc is more effective than wobble board to improve balance in diabetic neuropathy patients.

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Effects of Multisensory Training on Balance and Gait in Persons with Type 2 Diabetes: A Randomised Controlled Trial

Abstract: ABSTRACT

Cited by 14 publications

References 31 publications

Dynamic balance and neuropathic changes following ankle proprioceptive training in type II diabetic patients with peripheral neuropathy

Dynamic balance and neuropathic changes following ankle proprioceptive training in type II diabetic patients with peripheral neuropathy

Multisensory Exercise Improves Balance in People with Balance Disorders: A Systematic Review

Comparison of Exercises on two Unstable Surfaces for Balance and Gait Reeducation in Patients with Diabetic Peripheral Neuropathy

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