Postural control and functional strength in patients with type 2 diabetes mellitus with and without peripheral neuropathy

Abstract

Objective: To assess the influence of diabetic neuropathy (DN) on balance and functional strength in patients with diabetes mellitus type 2 (DM2).

Design: Cross-sectional study.

Setting: Diabetes outpatient unit.

Participants: Adults (N=62; age range, 40-65y): 32 with DM2 (19 subjects without DN and 13 with DN) and 30 without DM2 (control group).

Interventions: Not applicable.

Main outcome measures: Upright balance, evaluated in 4 situations (fixed platform, unstable platform, with eyes open, with eyes closed), and functional strength, assessed with a five-times-sit-to-stand test, were analyzed using an electromagnetic system, with a sensor placed over C7 to allow maximum trunk displacements in the anterior-posterior and medial-lateral directions. The Berg Balance Scale and the Timed Up & Go test were also used.

Results: Subjects with DM2 had greater anterior-posterior displacement (P<.05) in the unstable platform with eyes closed condition compared with those without DM2, whereas no difference in medial-lateral displacement was observed between these groups. A difference in time was observed in the five-times-sit-to-stand test (P<.05), with subjects in the control group performing the tasks faster than either group of subjects with DM2. Additionally, subjects in the control group showed a higher score in the Berg Balance Scale and performed the Timed Up & Go test in less time compared with subjects in other groups.

Conclusions: Subjects with DM2, with or without DN, showed deficits in postural control and functional strength compared with healthy individuals of the same age group.

Keywords: AP; BBS; Berg Balance Scale; DM; DM2; DN; Diabetic neuropathies; FPEC; FPEO; FTSST; ICC; ML; Rehabilitation; TUG; Timed Up & Go; UPEC; UPEO; anterior-posterior; diabetes mellitus; diabetes mellitus type 2; diabetic neuropathy; five-times-sit-to-stand test; fixed platform with eyes closed; fixed platform with eyes open; intraclass correlation coefficient; medial-lateral; unstable platform with eyes closed; unstable platform with eyes open.