Dynamic stability training improves standing balance control in neuropathic patients with type 2 diabetes

Abstract

Abstract-Patients with type 2 diabetic neuropathy (DN) are at an increased risk of falls due to the decreased accurate proprioceptive feedbacks. Effective balance training should treat context-specific instabilities of postural control of patients with DN. For this purpose, evaluations and balance training were designed with a 3-week baseline with evaluation after 3 weeks, followed by training over 3 weeks with reevaluation. We acquired control scores for standing balance from the Biodex stability system and fluctuations of the center of pressure. We performed repeated measure analysis of variance to test mean differences in three sessions of assessments. In addition, we compared mean differences of each pair of sessions with the least significant difference test. We used the paired t-test to compare the pure effects of trainings. Our investigation showed that the results of Biodex stability scores and force platform medial-lateral sway measurements improved statistically. Significant higher open-eyes median and mean frequency values of postural sway in the medial-lateral direction indicated that balance training allowed patients to develop control over the degree of freedom at the hip joint. In conclusion, training that compensates for disordered balance indicated by subclinical constraints with respect to the guidance effect of external visual feedback improves standing postural control in patients with type 2 DN.Clinical Trial Registration: Clinical Trial Registration: UMIN-CTR Search Clinical Trials, UMIN000004485, "Dynamic stability training can promote quiet standing control in neuropathic patients with type 2 diabetes"; http:// www.umin.ac.jp/ctr/index.htm.

Effect of balance training with Biodex Stability System on balance in diabetic neuropathy

“…Bulat and colleagues observed that a balance training class was safe and effective in improving balance outcomes in a cohort of elderly veterans at risk for falls with significant increase in berg balance score [Bulat et al 2007]. The usefulness of balance training with BBS in improving postural stability and balance is welldemonstrated in previous studies in elderly people, especially those with neuropathy, diabetes and DN [Akbari et al 2006[Akbari et al , 2012Salsabili et al 2011]. Similarly, Morrison and colleagues showed that, following training, the diabetic group exhibited a significant decline in falls risk [Morrison et al 2010].…”

Biomechanical evaluation of the relationship between postural control and body mass index

“…Additionally, there are six conditions that affect an individual's ability to maintain balance and postural control. These are biomechanical task constraint, movement strategies, orientation in space, controls of dynamics, sensory strategies and cognitive processing (Salsabili et al, 2011). Shumway-Cook and Woollacott (2007) described that there is a small amount of spontaneous postural sway in quiet standing.…”

Basics of Peripheral Nerve Injury Rehabilitation

“…There are even specific devices designed for proprioception training, such as the exercise ball, which works on balancing the abdominal and back muscles which may be impaired in nerve's root injuries. [10,11] …”