Diabetic peripheral neuropathy compromises balance during daily activities

Area of Science:

• Biomechanics
• Neurology
• Gerontology

Background:

• Diabetic peripheral neuropathy (DPN) significantly increases fall risk in patients with diabetes.
• Falls in diabetic patients can lead to hospitalization and reduced quality of life.
• Understanding balance deficits during dynamic activities is crucial for fall prevention strategies.

Purpose of the Study:

• To assess balance control during level walking and stair negotiation in patients with DPN.
• To compare balance parameters between DPN patients, diabetes patients without neuropathy, and non-diabetic controls.
• To identify biomechanical factors contributing to falls in DPN.

Main Methods:

• Gait analysis using motion capture and force plates during level walking and stair negotiation.
• Measurement of center of mass (COM) and center of pressure (COP) separation.
• Comparison of balance parameters across three groups: DPN, diabetes without neuropathy (D), and non-diabetic controls (C).

Main Results:

• DPN patients showed significantly greater COM-COP separations in medial-lateral and anterior directions during walking and stair negotiation compared to controls.
• Increased medial-lateral separations were observed during stair descent, stair ascent, and level walking in DPN patients.
• No significant balance differences were found in diabetes patients without neuropathy compared to controls.

Conclusions:

• Elevated COM-COP separations in DPN patients indicate a greater challenge to maintaining upright posture.
• Higher medial-lateral separations necessitate increased muscular effort for postural control, contributing to fall risk.
• These findings suggest that DPN-related balance deficits, particularly sideways sway, increase the likelihood of falls.