Functional Balance and Its Determinants in Older People with Diabetes

Abstract

ObjectiveTo determine functional balance abilities of older adults with diabetes, and identify determinants of these abilities.MethodsEighty diabetic and 67 healthy non-diabetic community-dwelling older adults completed the Mini Mental Status Examination (MMSE) and questionnaires about their medical and fall histories. Participants were also assessed for vision, plantar sensitivity, muscle strength, and functional balance, including Functional Reach (FR), Five Times Sit-to-Stand (FTSTS), and 180° turn (TURN). In addition to between-group comparisons, hierarchical regression analysis was conducted to identify the independent determinants for each of the individual balance tasks for the diabetes and control group separately.ResultsThe diabetes group had significantly greater body mass index, higher rate of cardiac disease, and poorer plantar sensitivity, mental status, grip and lower limb strength. The diabetes group performed significantly poorer in FTSTS and TURN (both p<0.001), but not FR (p = 0.108). The significant determinants for the balance tasks varied substantially between tasks and groups. For the diabetes group, they included visual and plantar sensitivity and MMSE for FR (R2 = 0.39), ankle dorsiflexion strength for FTSTS (R2 = 0.377), and plantar sensitivity, knee extension strength and MMSE for TURN (R2 = 0.391). For the control group, knee extension strength emerged as the common and only significant determinant and only explained approximately 10% of the variance for FR and TURN.ConclusionsImpairments in functional balance abilities were evident for older adults with diabetes. Their underpinning functional limitations were different for different tasks and were also different from those of the control group. Screening of functional balance and mental status, lower limb strength and sensory function, and interventions to address these impairments may be important to maintain function, independence and safety for older clients with diabetes.

A Study to Evaluate Subclinical Muscle Strength Decrease and Quality of Life among Diabetes Individuals

“…This measure showed increased time duration to perform sit to stand activity in diabetic individuals, which reveals an apparent decline in lower extremity functional strength even though they did not exhibit any variation in the activity of daily living. In the previous studies, a longer FTSTS time has found to predict falls and disability in older adults and the performance of FTSTS in our diabetic individuals was found to be poorer than age-matched non-diabetic individuals 7 . The diabetic individuals even though are able to ambulate and perform their daily activities these changes remain subtle and may lead to permanent disability in the future.…”

“…According to the earlier study, dorsiflexors is the only significant determinant for FTSTS. The ankle dorsiflexor torque not only can stabilize the contact between the feet and the ground but also rotate the lower leg forward and help to add to the knee extension torque in bringing the body forward and upward 7 . The ability to generate ankle dorsiflexion torque (i.e.…”

Controle postural em indivíduos com diabetes mellitus do tipo 2 com vertigem, tontura e/ou desequilíbrio

“…This study aimed at evaluating postural control of an experimental group of patients with T2DM who presented vertigo, dizziness, and/or imbalance using Tetrax IBS TM static posturography due to the high prevalence of vestibular and body balance dysfunction in individuals with DM (2,5,15) . Corroborating the literature, nearly one in three patients with T2DM interviewed reported vertigo, dizziness and/or imbalance.…”

Falls in older people with diabetes: Identification of simple screening measures and explanatory risk factors

“…A strain gauge was fixed horizontally with straps on the lower shin, 10 cm above the ankle, after which the participant was given three attempts with the dominant leg to push against the strap as forcefully as possible. In addition, the five time sit to stand test was administered [27]. Participants were given a practice trial and then the second trial was taken as the test result.…”