This article is more than 5 years old. Information may no longer be current.
Self-perceived unsteadiness influences balance, gait in diabetic neuropathy
In adults with diabetic peripheral neuropathy, self-perceived unsteadiness was associated with balance and gait measures, according to published findings.
“Unsteadiness and associated restrictions in activities of daily living predict depressive symptoms in patients with [diabetic peripheral neuropathy], highlighting the negative spiral between [diabetic peripheral neuropathy], unsteadiness, falls and psychological distress,” Neil D. Reeves, PhD, professor of musculoskeletal biomechanics at the School of Healthcare Science at Manchester Metropolitan University, United Kingdom, and colleagues wrote. “However, because unsteadiness has been assessed by self-report in most previous studies, it remains unknown whether a person’s perception of unsteadiness actually correlates with objective measures of balance and gait.”
Reeves and colleagues analyzed data from three groups of patients: adults with diabetic neuropathy (neuropathy disability score ≥ 6; n = 15), patients with diabetes but no neuropathy (n = 15) and matched controls without diabetes (n = 19). All participants completed the neuropathy-specific quality-of-life questionnaire to assess self-perceived unsteadiness during walking and standing. Participants underwent gait analysis using a 10-camera motion analysis system and force platforms while walking at a self-selected speed; dynamic sway was also measured.
Researchers found that the diabetic neuropathy group reported more self-perceived unsteadiness vs. those with diabetes but no neuropathy or controls (P < .0001). Participants with diabetic neuropathy also had reduced gait velocity and step length vs. controls (P < .0001), as well as altered body center-of-mass movement (P < .05). Researchers observed strong correlations between self-perceived unsteadiness and gait velocity, step length and severity of diabetic peripheral neuropathy.
“The novelty of the current study is in showing that [diabetic peripheral neuropathy] patients are not only aware of themselves as being unsteady, but actually attempt to self-regulate their unsteadiness by walking more slowly and taking shorter steps,” the researchers wrote. “These gait adjustments reduce the extent to which [diabetic peripheral neuropathy] patients need to move their body forward, away from their base of support, during each step.”
The researchers noted that self-perceived unsteadiness in participants with diabetes but without diabetic peripheral neuropathy was no different from that of controls without diabetes. The researchers did not assess fear of falling, depression or fall history of participants. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.