Pain, Physical Activity, Kinesiophobia, Balance and Fall Risk in Patients with Diabetic Neuropathy

In this study, we aimed to investigate the risk of balance disorders and falls in patients with diabetic neuropathic pain and the associated kinesiophobia and physical limitation.

This study was designed as a cross-sectional descriptive study and was conducted with 250 patients seen in Family Medicine outpatient clinics between February and March 2023. The Tampa Kinesiophobia Scale (TSK) was used to measure the patients' fear of movement/reinjury, the International Fall Efficacy Scale (FES-I) was used to measure the level of fear of falling, the Berg Balance Scale (BBS) was used to assess balance status, and the International Physical Activity Questionnaire (IPAQ) was used to assess all activities during the day. Patients were divided into three groups according to pain patterns: Neuropathic pain (N = 74), nociceptive/mechanical pain (N = 96), and control group (no pain) (N = 90). In statistical analyses, p < .05 was considered significant.

The mean age was 62.56 ± 9.81 years in the neuropathic pain group, 62.47 ± 11.67 years in the nociceptive/mechanical pain group, and 60.87 ± 10.99 years in the control group. Overall, 60% of the participants were women. In intergroup analyses, there were significant differences between the groups in terms of TSK (p = .012), FES-I (p < .001), IPAQ (p < .001), and BBS (p < .001). The neuropathic pain group had the lowest BBS scores. When comparing the neuropathic pain group to the control group, TSK was significantly higher (p = .009).

Patients with neuropathic pain due to diabetes mellitus are more likely to have increased balance impairment, leading to decreased physical activity and an increased risk of falls.