Neuropathy Affects Balance

Today's post from care.diabetesjournals.org (see link below) is all over the internet in various forms at the moment but to my mind is pretty much another 'duh!' moment as far as neuropathy news is concerned. Almost every experienced neuropathy patient will be able to tell you that their neuropathy has compromised their balance in some way and it doesn't take a great deal of imagination to understand why (given the other symptoms we experience). However, these things all have to be proved in one way or another via studies and research and this article does go into the science behind balance issues. Worth a read but you knew it didn't you?

Diabetic Peripheral Neuropathy Compromises Balance During Daily Activities
Published online before print March 12, 2015, doi: 10.2337/dc14-1982 Diabetes Care March 12, 2015

Steven J. Brown1⇑,
Joseph C. Handsaker1,
Frank L. Bowling2,
Andrew J.M. Boulton2 and
Neil D. Reeves1

+ Author Affiliations
1School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, U.K.
2Faculty of Medical and Human Sciences, University of Manchester, U.K.
Corresponding author: Steven J. Brown, s.brown@mmu.ac.uk.

Abstract

OBJECTIVE 
Patients with diabetes with peripheral neuropathy have a well-recognized increased risk of falls that may result in hospitalization. Therefore this study aimed to assess balance during the dynamic daily activities of walking on level ground and stair negotiation, where falls are most likely to occur.

RESEARCH DESIGN AND METHODS 
Gait analysis during level walking and stair negotiation was performed in 22 patients with diabetic neuropathy (DPN), 39 patients with diabetes without neuropathy (D), and 28 nondiabetic control subjects (C) using a motion analysis system and embedded force plates in a staircase and level walkway. Balance was assessed by measuring the separation between the body center of mass and center of pressure during level walking, stair ascent, and stair descent.

RESULTS 
DPN patients demonstrated greater (P < 0.05) maximum and range of separations of their center of mass from their center of pressure in the medial-lateral plane during stair descent, stair ascent, and level walking compared with the C group, as well as increased (P < 0.05) mean separation during level walking and stair ascent. The same group also demonstrated greater (P < 0.05) maximum anterior separations (toward the staircase) during stair ascent. No differences were observed in D patients.

CONCLUSIONS 
Greater separations of the center of mass from the center of pressure present a greater challenge to balance. Therefore, the higher medial-lateral separations found in patients with DPN will require greater muscular demands to control upright posture. This may contribute to explaining why patients with DPN are more likely to fall, with the higher separations placing them at a higher risk of experiencing a sideways fall than nondiabetic control subjects.
Received August 18, 2014.
Accepted February 17, 2015. 

© 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. 

http://care.diabetesjournals.org/content/early/2015/03/11/dc14-1982.abstract