Postural performance assessment in aging people with diabetes and diabetic peripheral neuropathy using a Wii balance board

Abstract

Purpose To determine the effect of sensory perturbations on static postural control in older people with type 2 diabetes mellitus by comparing postural outcomes of people with and without diabetic neuropathy using a Wii Balance Board (WBB). Materials and methods Static postural balance assessments were performed in 31 participants: nine with type 2 diabetes mellitus; 12 with diabetic neuropathy; and 10 non-diabetic controls. Participants stood on the WBB under sensory perturbations (visual and proprioceptive). Body balance was analysed using centre of pressure ellipse area, mean velocity, and sample entropy. The effects of within-participant factors, sensory perturbations and the between-participants factor ‘group’ on outcomes were analysed using a multivariate analysis of variance model. Results Type 2 diabetes mellitus participants with and without neuropathy showed altered postural performance under sensory perturbations compared to non-diabetic participants. Moreover, participants with diabetic neuropathy showed impaired postural performance when one perceptual system was disturbed. Finally, participants with type 2 diabetes mellitus without neuropathy decreased their postural performance when both sensory disturbances were present. Conclusions The Wii Balance Board can be a useful alternative for balance impairment screening related to diabetic neuropathy and contribute as an affordable source of insight in early interventions in integral diabetes care. Implications to rehabilitation Older people with diabetic peripheral neuropathy depend on visual and somatosensory cues to keep their static postural balance. Static balance assessment using the Wii Balance Board allows the identification of alterations in postural performance in participants with diabetes. This low-cost method used can be considered as a complement to integral diabetes care.