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Functional Vestibular Abilities in Children and Adolescents With and Without Type 1 Diabetes Mellitus: Preliminary
Anwar B Almutairi1, Jennifer B Christy2
1Department of Physical Therapy College of Allied Health Sciences, Kuwait University Shadadiya Kuwait.
Purpose:
The aim of this study was to explore functional use of the vestibular system in children and adolescents with type 1 diabetes mellitus (T1DM) aged between 10 and 17 years compared to age and gender-matched control group using a comprehensive battery of standardized tests.
Materials And Methods:
Participants with T1D were recruited from hospitals in Kuwait. The control group was recruited through social media. All participants went through functional vestibular system testing that included: (1) clinical dynamic visual acuity (cDVA), (2) the head impulse test (HIT), (3) the modified clinical test of sensory interaction on balance (mCTSIB), (4) the bucket test of subjective visual vertical (SVV), and (5) functional gait assessment (FGA).
Results:
A group of 11 children and adolescents were (female n = 5 [45.45%], mean age = 13.64 years, SD = 2.69) compared with 11 age and gender-matched peers without T1DM. All participants tolerated vestibular testing. Significant differences between groups were seen in the overall scores of the mCTSIB (T1DM = 111.54, SD = 13.92 vs. control = 118.73, SD = 2.43, p = 0.001) and specifically, condition 4 (T1DM = 23.33, SD = 10.45 vs. control = 29.09, SD = 2.28, p < 0.001) compared to their peers. None of the other tests were significantly different between the groups. Only 18% of the T1DM group (n = 2) had a positive HIT. SVV variance was positively correlated with HbA1C (r(9) = 0.772, p = 0.005).
Conclusions:
Children and adolescents with T1DM had more difficulty using vestibular function to resolve sensory conflict for postural control compared to their peers without T1DM. The finding suggests that dynamic visual acuity and functional gait were comparable between groups. Although not significantly different between groups, the variance of perception of verticality was correlated with glycemic control.
Level Of Evidence:
Level 4.
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