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Peripheral neuropathy effect on ankle inversion and eversion detection thresholds

C G Van den Bosch1, M G Gilsing, S G Lee

  • 1Department of Mechanical Engineering and Applied Mechanics, University of Michigan, Ann Arbor 48109-2125, USA.

Archives of Physical Medicine and Rehabilitation
|September 1, 1995
PubMed
Summary

Geriatric patients with peripheral neuropathy (PN) have significantly impaired ankle proprioception, requiring larger movements to detect rotation compared to controls. This sensory deficit, particularly noticeable at the toes, may impact balance.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Biomechanics

Background:

  • Peripheral neuropathy (PN) is common in the elderly and can affect sensory function.
  • Ankle proprioception is crucial for maintaining balance, especially during unipedal stance.
  • Deficits in proprioception are theoretically linked to an increased risk of falls in older adults.

Purpose of the Study:

  • To quantify ankle proprioception thresholds in geriatric patients with PN.
  • To compare sensory perception of ankle rotation between patients with PN and healthy controls.
  • To investigate the relationship between ankle proprioception deficits and clinical measures of neuropathy.

Main Methods:

  • Utilized a servo-controlled foot platform to measure ankle inversion and eversion perception thresholds.

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  • Recruited seven geriatric patients with confirmed PN and seven age/gender-matched controls.
  • Assessed proprioceptive acuity in bipedal and unipedal stances, and performed clinical tests on ankle and toe position sense.

    • Main Results:

    • The PN group exhibited a 4.6-fold higher threshold for detecting ankle rotation (1.37° vs 0.3°).
    • Inversion perception was approximately twice as acute as eversion perception in both groups.
    • PN patients showed better proprioception in unipedal vs. bipedal stance, unlike controls.
    • Clinical toe position sense was impaired in all PN patients, but ankle position sense was largely preserved.

    Conclusions:

    • Geriatric peripheral neuropathy is associated with significant deficits in ankle proprioception.
    • These proprioceptive impairments, especially loss of toe position sense, may compromise unipedal balance maintenance.
    • Standard clinical ankle tests may underestimate the extent of proprioceptive loss in PN.