Abstract
ObjectiveIndividuals with diabetic peripheral neuropathy (DPN) have functional deficits that increase their risk of falling. However, psychological aspects such as loss of confidence in undertaking activities could also contribute to this risk. We examined correlations between balance confidence and fall risk among individuals with DPN.MethodsThis was a cross-sectional study of 146 individuals with DPN. Elevated fall risk was determined by timed up-and-go test with standard cut-off time of 13.5 seconds, and balance confidence was measured by 16-item Activities Specific Balance Confidence scale. Functional parameters assessed included functional reach, body sway velocity during quiet standing and muscle strength at ankle and toe.ResultsTwenty percent of the DPN patients were at increased risk of falls. Every unit increase in balance confidence was associated with 9% (95% confidence interval: 0.88, 0.95; p<0.001) reduced odds of falling, after adjusting for socio-demographic, health and functional characteristics. No other functional parameters had significant associations with fall risk in adjusted analyses.ConclusionsPsychological factors like balance confidence appear to be more important for fall risk among DPN patients, compared to objective functional performance. Interventions targeting balance confidence may be beneficial in reducing the risk of falls in this population.
Highlights
Diabetic peripheral neuropathy (DPN) may lead to muscle weakness, loss of ankle reflexes, and impairment in balance, coordination and gait control [1], which significantly increase the risk of falling and sustaining fall-related injuries [2,3,4]
We examined relationships between balance confidence, balance performance and fall risk among DPN patients
Our DPN patients were in their early 60s, and majority were Indians (Table 1)
Summary
Diabetic peripheral neuropathy (DPN) may lead to muscle weakness, loss of ankle reflexes, and impairment in balance, coordination and gait control [1], which significantly increase the risk of falling and sustaining fall-related injuries [2,3,4]. Fall Risk and Balance Confidence in DPN falling. Low confidence in undertaking activities is prevalent among diabetic patients, [5] and could be more common in DPN patients given their higher rate of alterations in balance and gait. It is not clear if lower balance confidence is associated with higher fall risk among DPN patients. We examined relationships between balance confidence, balance performance and fall risk among DPN patients
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