Postural Rearrangement in IDDM Patients With Peripheral Neuropathy

Giacomini, P; Bruno, Ernesto; Monticone, Giovanna; Girolamo, Stefania Di; Magrini, Andrea; Parisi, Luca; Menzinger, G.; Uccioli, Luigi

doi:10.2337/diacare.19.4.372

Cited by 50 publications

(29 citation statements)

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“…In total, 24 articles were excluded from detailed review. 1,2,10,15,16,18,22,[27][28][29][30][31]33,[37][38][39][40][43][44][45]48,49,51,52 Ten of the articles 19,[23][24][25][26]34,36,46,47,50 described the effect of DN on balance. Two included articles 41,42 described the effect of Charcot-Marie-Tooth disease (CMT) type 1A (CMT1A) or type 2 (CMT2) on balance.…”

Section: Resultsmentioning

confidence: 99%

“…5,19,[23][24][25][26]32,[34][35][36]41,42,46,47,50 Thirteen of the 39 initially selected articles were excluded because no measures of somatosensation were presented. 1,22,[27][28][29][30]38,40,[43][44][45]48,51 Six of the selected articles 10,18,31,33,49,52 were excluded because the balance measurements did not refer to standing balance. Two articles 2,16 were excluded because there was no comparison with a control group or a standardized norm.…”

Section: Resultsmentioning

confidence: 99%

“…Based on title and abstract, 453 articles were excluded. Three articles 19,22,23 were added after examining the references of the 36 selected articles, resulting in 39 articles 1,2,5,10,15,16,18,19, to be assessed for detailed review. Before the consensus meeting, a disagreement originated from misreading sentences or misunderstanding the terminology used in the articles, between the two reviewers, about 14 articles.…”

Section: Resultsmentioning

confidence: 99%

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The Effect of Reduced Somatosensation on Standing Balance: A Systematic Review

Kars

Hijmans

Geertzen

et al. 2009

J Diabetes Sci Technol

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Effect of Reduced Somatosensation on Standing Balance: A Systematic Review

Kars

Hijmans

Geertzen

et al. 2009

J Diabetes Sci Technol

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“…This increased risk is presumably due to the well-documented balance problems attributed to neuropathy [1] and sensory ataxia, which is the lack of accurate proprioceptive feedback [2]. Sources of instability in patients with type 2 DN include the loss or reduction of peripheral sensory information in the feet [3][4], the inability of the central nervous system (CNS) to appropriately integrate available postural control information [2,[4][5], and a switch from an ankle-based to a hip-based balance strategy [6][7][8][9][10]. In addition, an increase in the use of vestibular information and dependence on visual information [11] alter the style of postural control in patients with DN.…”

Section: Introductionmentioning

confidence: 99%

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

Salsabili

Bahrpeyma²,

Forogh³

et al. 2011

JRRD

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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.

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“…It is not clear which is the main somatosensory determinant of postural instability; however, it has been observed that instability increases according to neuropathy severity (14)(15)(16). Diabetic individuals have worse adaptation to sensory conflictive situations, and present a greater dependence on visual input, similarly to what happens to aging (14,16,17), but with a great difficulty in carrying out visual-vestibular compensation (18).…”

mentioning

confidence: 99%

Factors associated with functional balance and mobility among elderly diabetic outpatients

Cordeiro

Jardim

Perracini

et al. 2009

Arq Bras Endocrinol Metab

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Objectives: To characterize balance and mobility among diabetic elderly outpatients and to estimate the extent to which functional balance and mobility abnormalities can be influenced by sociodemographic, clinical and other functional factors in a cross-sectional study. Methods: Ninety-one elderly (65+ years) outpatients were assessed. Mobility was evaluated by the Timed Up and Go Test (TUGT) and the balance, by the Berg Balance Scale (BS). Results: TUGT mean score was 15.65 ± 5.9 seconds and BS mean score was 49.31 ± 7.3 points. Using linear regression analysis (α ≤ 0.05), significant and independent positive relationships were obtained between TUGT and age, daily activities (ADL/IADL), step strategy, and proprioceptive sensitivity. Factors negatively associated with BS were: ADL/IADL, step strategy, proprioceptive sensitivity, orthostatic hypotension (OH) and conflictive sensory conditions. Conclusion: Elderly diabetic outpatients show abnormal balance and mobility related mainly to advanced age, disability, absence of step strategy, absence of proprioceptive sensitivity and presence of OH. Arq Bras Endocrinol Metab. 2009;53(7):834-43. KeywordsAged; frail elderly; activities of daily living; postural balance; mobility limitation; diabetes mellitus, type 2 resumo Objetivos: Caracterizar o equilíbrio e a mobilidade de idosos diabéticos ambulatoriais e estimar o quanto suas anormalidades podem ser influenciadas por fatores sociodemográficos, clínicos e funcionais globais em um estudo transversal. Métodos: 91 idosos (65 + anos) ambulatoriais foram avaliados quanto à mobilidade pelo Timed Up and Go Test (TUGT) e ao equilíbrio, pela Berg Balance Scale (BS). Resultados: A média dos escores do TUGT foi de 15,65 ± 5,9 segundos e da BS, de 49,31 ± 7,3 pontos. Empregando-se análise de regressão linear (α ≤ 0,05), associações significantes positivas e independentes foram obtidas entre o TUGT e idade, atividades cotidianas, estratégia do passo atrás e sensibilidade proprioceptiva. Os fatores associados negativamente à BS foram: atividades cotidianas, estratégia do passo, sensibilidade proprioceptiva, hipotensão ortostática (HO) e condições sensoriais conflituosas. Conclusão: Idosos diabéticos ambulatoriais apresentam equilíbrio e mobilidade prejudicados, relacionados principalmente à idade avançada, limitação para atividades diárias, ausência de estratégia de equilíbrio, prejuízo na sensibilidade proprioceptiva e a presença de HO. Arq Bras Endocrinol Metab. 2009;53(7):834-43. DescritoresIdoso; idoso frágil; atividades cotidianas; equilíbrio postural; limitação da mobilidade; diabetes melito tipo 2.

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Postural Rearrangement in IDDM Patients With Peripheral Neuropathy

Abstract: Diabetic patients with peripheral neuropathy demonstrate a shift from physiological ankle control to hip postural control as monitored by specific posturography analysis.

Cited by 50 publications

References 0 publications

The Effect of Reduced Somatosensation on Standing Balance: A Systematic Review

The Effect of Reduced Somatosensation on Standing Balance: A Systematic Review

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

Factors associated with functional balance and mobility among elderly diabetic outpatients

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