March 17, 2015
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Diabetic peripheral neuropathy impedes balance during daily activities

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Adults with diabetic peripheral neuropathy have greater separations between the body’s center of mass and the center of pressure during movement and are therefore more likely to lose their balance than people without neuropathy, according to research published in Diabetes Care.

The higher medial-lateral separations observed as affected participants walked on level ground, or up and down stairs, puts more demand on muscles to remain upright and could partly explain the increased risk for falling sideways, according to researchers.

“For the first time, we have shown that balance is markedly impaired in patients with diabetic peripheral neuropathy during the gait activities of level ground walking, stair ascent and stair descent,” the researchers wrote.
Steven J. Brown, a PhD student at Manchester Metropolitan University, U.K., and colleagues analyzed the gaits of 22 participants with diabetic neuropathy, 39 people with diabetes without neuropathy and 28 individuals without diabetes during level walking and stair negotiation using a motion analysis system and embedded force plates in a walkway and staircase.  

The investigators assessed balance by measuring the separation between the body center of mass and center of pressure during level walking, stair ascent and stair descent.

During stair descent, stair ascent and level walking, participants with diabetic neuropathy demonstrated greater (P < .05) maximum and range of separations between their center of mass and center of pressure in the medial-lateral plane compared with the group without diabetes; the mean separation was similarly increased (P < 0.05) during level walking and stair ascent.

Participants with diabetic neuropathy also showed greater (P < 0.05) maximum anterior separations (toward the staircase) during stair ascent. No differences were observed in participants with diabetes but no neuropathy.

“We have shown marked impairments in dynamic sway during gait activities in patients with (diabetic peripheral neuropathy), which become more evident with increasing gait task complexity,” the researchers wrote. “Impaired balance in patients with diabetic peripheral neuropathy may also be linked to a compensatory mechanism (increased stance width) that is used because of perceived instability but may actually increase the risk of falling.” – by Allegra Tiver

Disclosure: The researchers report no relevant financial disclosures.