Abstract
BackgroundType 2 diabetes (T2D) is a cause of multiple complications, including retinopathy and peripheral neuropathy. These complications are well understood and believed to contribute to gait instability. Poor balance control and increased falling risk have also been reported in people with diabetic peripheral neuropathy (DPN).Patients with DPN have increased risk of falling due to decreased proprioceptive feedback. Effective balance training should improve postural control in patients with DPN. For this purpose further evaluation was conducted and balance training was designed.MethodsThe goal of our study was to determine values of proprioception, balance, muscle coordination and strength in patients with T2D and analyze whether biofeedback balance training with use of the Biodex Balance System could improve these parameters. To assess the fall risk the general stability index (GSI), the index of frontal-posterior (FPI) and medial–lateral (MLI) stability were evaluated. 37 patients with diagnosed type 2 diabetes mellitus were recruited to this study. Their results were compared with control group consisting of 41 healthy participants who were homogenic to the study group in terms of age and body mass index (BMI).ResultsThere were statistically significant differences between patients with diabetes compared to healthy subjects in GSI (2.79 vs 1.1), FPI (1.66 vs 0.7), MLI (0.88 vs 0.52) and risk of falling (5.18 vs 2.72) p < 0.05. There were also statistically significant changes before and after training in all stability indices (GSI: 2.79 vs 1.26, FPI: 1.66 vs 0.77, MLI: 0.88 vs 0.54 accordingly) p < 0.05 and risk of falling (5.18 vs 3.87) p < 0.05 in the study group who had undergone training with biofeedback.ConclusionsThis study found that there is a decreased balance and motor coordination and an increased risk of falling in patients with type 2 diabetes. These parameters improved in patients who have undergone training programme with biofeedback. Furthermore, an age-dependent deprivation of static balance was observed along with an increased risk of falling as a result of increasing BMI.
Highlights
Type 2 diabetes (T2D) is a cause of multiple complications, including retinopathy and peripheral neuropathy
One of the most common is peripheral neuropathy (DPN) causing damage to the peripheral sensory and motor nerves even in mild to moderate course of the disease [4]. It is well proved in the literature, that diabetes mellitus has a negative impact on function of the peripheral nervous system by damaging its sensory fibers with age and male sex being the most important risk factors [5]
The study group consisted of 37 patients diagnosed and treated with T2D. 41 patients were recruited to the control group
Summary
Type 2 diabetes (T2D) is a cause of multiple complications, including retinopathy and peripheral neuropathy. Poor balance control and increased falling risk have been reported in people with diabetic peripheral neuropathy (DPN). One of the most common is peripheral neuropathy (DPN) causing damage to the peripheral sensory and motor nerves even in mild to moderate course of the disease [4]. It is well proved in the literature, that diabetes mellitus has a negative impact on function of the peripheral nervous system by damaging its sensory fibers with age and male sex being the most important risk factors [5]
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