Postural sway in individuals with type 2 diabetes and concurrent benign paroxysmal positional vertigo

Abstract

Background and Purpose Diabetes has been shown to affect the peripheral vestibular end organs and is associated with an increase in the frequency of benign paroxysmal positional vertigo (BPPV). People with diabetes have higher postural sway; however, the impact of symptomatic BPPV on postural sway in individuals with diabetes is unclear. The purpose of this cross-sectional study was to examine postural sway in people with type 2 diabetes who have symptomatic, untreated BPPV (BPPVDM). Methods Fifty-two participants (mean age 56.9 ± 5.6 years) were enrolled: controls (n=14), diabetes (n=14), BPPV only (n=13) and BPPVDM (n=11). An inertial motion sensor was used to detect pelvic acceleration across five standing conditions with eyes open/closed on firm/foam surfaces. Range of acceleration (cm/s2), peak velocity (cm/s), and variability of sway (RMS) in the anterior-posterior (AP) and medial-lateral (ML) directions were used to compare postural sway between groups across conditions. Results Participants with BPPVDM had higher ranges of acceleration in the AP (p=0.02) and ML (p=0.02) directions, as well as higher peak velocity (p<0.001) and RMS values (p=0.006) in the AP direction compared to the control and diabetes groups. Standing on foam with eyes closed and tandem stance were challenging conditions for people with BPPVDM. Conclusion Clinicians may consider using standing on foam with eyes closed and tandem standing with eyes open to assess postural control in people with BPPVDM to identify postural instability.

Presence of Anxiety and Depression Symptoms Affects the First Time Treatment Efficacy and Recurrence of Benign Paroxysmal Positional Vertigo

“…Although the efficacy of first time CRM was significantly affected by psychiatric symptoms (Tables 2 and 3 ), the total cumulative success rate at 1 month was 97.64%, which is slightly higher than the previously reported range of 70–95% ( 54 , 55 ). Comorbidities, such as hypertension and diabetes, had no significant effect on the treatment outcome of CRM, again consistent with previous findings ( 54 , 56 ). Lastly, it has been reported that BPPV patients who received higher numbers of maneuvers tended to have the greatest risk of recurrence, and the relapse largely occurs within the first few months ( 12 ).…”

Walking stability in patients with benign paroxysmal positional vertigo: an objective assessment using wearable accelerometers and machine learning

“…The sensor-based measurements of walking stability include acceleration root mean square (RMS) harmonic ratio (HR), gait variability, gait symmetry and gait regularity [14]. Previous studies have found that BPPV patients have impaired abilities in controlling static posture balance in mediolateral and anteroposterior axes [15,16], thus it may help us to gain insights into the BPPV disease better by analyzing the walking stability in various axes rather than purely studying the temporospatial gait variables. Furthermore, previous studies have found the significant associations between the vestibular dysfunction and the changes of gait and balance, thus offering a possibility to objectively assess the severity of gait disturbances imposed by BPPV disease [17][18][19].…”

Diseases and symptoms associated with changes in postural balance in diabetics: an integrating literature review

“…High body mass index (BMI) was described in three articles 17,18,20 , showing a population with high a BMI average, above 30 Kg/m 2 , in relation to the other groups. According to the World Health Organization, a BMI equal to or above 30 Kg/m 2 is characterized as obese 24 .…”