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Foot and ankle sensory neuropathy, proprioception, and postural stability
R W van Deursen1, G G Simoneau
1Department of Physiotherapy Education, University of Wales College of Medicine, Cardiff, United Kingdom.
The Journal of Orthopaedic and Sports Physical Therapy
|December 28, 1999
Summary
Diabetic neuropathy impairs foot and ankle sensory receptors, affecting balance and increasing fall risks. This highlights the need to assess balance deficits in diabetic patients for effective rehabilitation.
Area of Science:
- Neurology
- Diabetology
- Biomechanics
Background:
- Foot and ankle sensory neuropathy, common in diabetes mellitus, risks cutaneous injury due to decreased plantar sensation.
- Neuropathy also affects joint position and movement receptors, contributing to less obvious fall-related injury risks.
- Studies show diabetic neuropathy impacts these receptors, leading to reduced postural stability.
Purpose of the Study:
- To investigate the impact of foot and ankle sensory neuropathy on balance and postural stability.
- To emphasize the importance of assessing balance deficits in individuals with diabetic neuropathy.
Main Methods:
- Review of existing studies on diabetic neuropathy and sensory function.
- Analysis of the relationship between sensory deficits and postural stability tests.
- Evaluation of reported fall-related injuries and subjective feelings of instability.
Main Results:
- Diabetic neuropathy affects peripheral sensory receptors in the lower legs, including muscle spindles.
- Reduced sensory function correlates with decreased performance in static and dynamic postural stability tests.
- Increased incidence of fall-related injuries and subjective instability are reported in individuals with diabetic neuropathy.
Conclusions:
- Reduced postural stability in diabetic neuropathy is due to general peripheral sensory loss, not just plantar sensation.
- Balance deficits should be a key consideration during evaluation and rehabilitation planning for individuals with foot and ankle neuropathy.
- Assessing balance is crucial for those using modified footwear or with lower extremity amputations.