Investigation of standing balance in diabetic patients with and without peripheral neuropathy using accelerometers

Turcot, Katia; Allet, Lara; Golay, Alain; Hoffmeyer, Pierre; Armand, Stéphane

doi:10.1016/j.clinbiomech.2009.07.003

Cited by 66 publications

(52 citation statements)

References 36 publications

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“…This finding is similar to what was discovered by other authors, who stated that patients presenting peripheral neuropathy or DPN show balance alterations when contrasted with healthy subjects (15)(16)(17)(18)(21)(22)(23)(24)(25) and with subjects presenting DM without DPN (17,18,21,23,25). This statement is based on the fact that the tactile sensorial system is the main mechanism for balance (26); hence, when influenced by DPN, balance control is affected.…”

Section: Discussionsupporting

confidence: 75%

“…This statement is based on the fact that the tactile sensorial system is the main mechanism for balance (26); hence, when influenced by DPN, balance control is affected. Furthermore, higher CoP displacement under the closed eyes condition has also been evidenced by other authors (15,17,23,25), who stated that eliminating the visual stimulus affects postural control.…”

Section: Discussionmentioning

confidence: 56%

“…A number of investigations has been carried out on the influence of DPN in the balance of subjects with DM. Higher CoP displacements have been observed in patients presenting DPN, in contrast with those presenting DM without DPN and healthy individuals (15)(16)(17). Furthermore, Ghanavati and cols.…”

Section: Objetivosmentioning

confidence: 99%

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Equilíbrio estático em pacientes com diabetes melito tipo 2 com ou sem polineuropatia diabética

Palma

Antigual

Martínez

et al. 2013

Arq Bras Endocrinol Metab

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Objectives: To contrast the static balance in patients presenting diabetes mellitus type 2 (DM2) with and without polyneuropathy (DPN); and to correlate the rates from the scale Diabetic Neuropathy Examination (DNE) with the mean ratio of the center of pressure (CoP). Subjects and methods:Twenty patients, aged between 40 and 54, presenting DM2 and classified, according to DNE scale, in groups with (n = 10) and without (n = 10) DPN, were compared. Descritores Equilíbrio postural; polineuropatia diabética; diabetes melito tipo 2; complicações do diabetes

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 56%

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Equilíbrio estático em pacientes com diabetes melito tipo 2 com ou sem polineuropatia diabética

Palma

Antigual

Martínez

et al. 2013

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…11,18 One possible explanation for the differing results is that the sensory alterations combined with the biomechanical restrictions of movement, such as diminished perception of movement and deficits in the walking direction, can by themselves lead to compromised postural stability. 19 Other studies also demonstrate that alterations in some gait parameters are directly linked to sensory deficit among neuropathic diabetics, just as shown in the present study. 3,4,21 In another study neuropathic patients free of other infirmities, such as in the present study, showed alterations in their gait style, probably due to deficient motor innervation of the muscles associated with the development of the step, especially the dorsal and plantar flexors of the feet.…”

Section: Discussionsupporting

confidence: 73%

“…18 Next, a measurement of isometric strength was taken for the ankle dorsiflexors and plantar flexors using a digital dynamometer (model DD-300 Instrutherm, São Paulo, Brazil); the instrument was coupled to a platform designed to assess the isometric strength of the ankle. 19 To evaluate the balance under static conditions, the anteroposterior sway of the ankle was analyzed by measuring the angular variations with a kinematic system. 20 Two cameras were used for this, with a sampling rate of 60 Hz and with reflective markers affixed at pre-established anatomical points.…”

Section: Evaluations and Equipmentmentioning

confidence: 99%

Changes of the gait parameters and sensory-motor deficit associated with peripheral diabetic neuropathy

Martinelli¹,

Mantovani²,

Nozabieli³

et al. 2014

Acta Fisiátrica

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Peripheral nervous system impairment, with sensory and motor loss, as observed in diabetic neuropathy, can induce serious effects on balance control and gait in this population. Objective: To evaluate the performance of the gait and the sensory-motor changes, stemming from peripheral diabetic neuropathy (PDN). Method: Twenty-four individuals with PDN participated along with twenty-eight healthy individuals with no glycemic alterations indicative of diabetes. Participants were first subjected to clinical evaluations to confirm the clinical diagnosis of diabetic neuropathy by testing the tactile sensitivity of the soles of the feet with a monofilament test. Subsequently, ankle angle variations in static posture and during the gait were investigated through kinematics. The ankle muscle strength was investigated using a digital dynamometer. Results: The diabetic neuropathy group showed longer duration in double support and full support periods of gait than the control group, confirming greater difficulty in dynamic balance for these individuals. The group with neuropathy demonstrated reduced muscle strength, as much in the dorsiflexors as in the plantar flexors of the ankle. Conclusion: The sensory-motor losses stemming from PDN may cause impairment in gait performance, with consequent loss of balance.Keywords: Gait, Muscle Strength, Postural Balance, Diabetic Neuropathies RESUMOQuando há dano no sistema nervoso periférico, com prejuízos sensoriais e motores, como observado em neuropatas diabéticos, podem ocorrer graves repercussões sobre o equilíbrio e a locomoção nesta população. Objetivo: Avaliar o desempenho da marcha e alterações sensório-motoras, decorrentes da neuropatia diabética periférica. Método: Participaram 24 indivíduos neuropatas diabéticos e 28 indivíduos saudáveis sem alterações glicêmicas indicativas de diabete. Os participantes foram submetidos inicialmente a avaliações clínicas para confirmação de diagnóstico de neuropatia diabética por meio de teste de sensibilidade tátil da sola dos pés com monofilamentos. Posteriormente, foram submetidos à avaliação da variação angular do tornozelo, em condição estática e durante a marcha, por meio de cinemetria. A força muscular do tornozelo foi investigada por meio de dinamometria digital. Resultados: Foi demonstrado maior duração nos períodos de duplo apoio e apoio total da marcha em indivíduos com neuropatia diabética quando comparados com o grupo controle, confirmando uma maior dificuldade no equilíbrio dinâmico destes indivíduos. Para o grupo experimental de indivíduos neuropatas foi evidenciado redução da força muscular, tanto para os músculos dorsiflexores, quanto para os plantiflexores de tornozelo. Conclusão: As perdas sensório-motoras decorrentes da NDP podem implicar em prejuízo no desempenho da marcha, com consequente perda de equilíbrio.

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Cognitive impairment and postural control deficit in adults with Type 2 diabetes

Gorniak

Lee

et al. 2018

Diabetes Metabolism Res

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Background Diseases induced by metabolic disorders, eg, Type 2 diabetes, has recently been linked to both sensory and motor deficit in the absence of a formal clinical diagnosis of peripheral neuropathy. Studies have demonstrated mild cognitive impairment in diabetic patients, which also plays a role in one's loss of ability to successfully perform basic motor activities. This project focused on evaluating cognitive function while maintaining balance. We hypothesized that simultaneous cognitive and motor deficit would occur among adults with Type 2 diabetes versus healthy age‐ and sex‐matched control during a balance task. Methods A sample of 10 Type 2 diabetes patients and 10 age‐matched and sex‐matched controls underwent a series of sensory, motor, cognitive, and cognitive‐motor evaluations. Blood pressure and A1c levels were assessed. Results Significantly lower cognitive function scores, particularly in the domain of working memory, were exhibited in the diabetic group than controls. Balance in the diabetic group was overall poorer in both single‐ and dual‐tasks than controls. When diabetic patients were asked to verbally recall different words while maintaining their balance, their accuracy rate was significantly lower than controls. Some health state measures were found to co‐vary with motor function. Increased body mass index in the diabetic group did not account for motor function deficit. Significance Our data suggest that: (1) systemic deficit beyond tactile dysfunction and increased body mass index contribute to reduced motor function in diabetes, and (2) both balance and working memory functions are simultaneously impaired in patients with Type 2 diabetes.

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Investigation of standing balance in diabetic patients with and without peripheral neuropathy using accelerometers

Cited by 66 publications

References 36 publications

Equilíbrio estático em pacientes com diabetes melito tipo 2 com ou sem polineuropatia diabética

Equilíbrio estático em pacientes com diabetes melito tipo 2 com ou sem polineuropatia diabética

Changes of the gait parameters and sensory-motor deficit associated with peripheral diabetic neuropathy

Cognitive impairment and postural control deficit in adults with Type 2 diabetes

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