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Brognara L, Sempere-Bigorra M, Mazzotti A, Artioli E, Julián-Rochina I, Cauli O. Wearable sensors-based postural analysis and fall risk assessment among patients with diabetic foot neuropathy. J Tissue Viability 2023; 32:516-526. [PMID: 37852919 DOI: 10.1016/j.jtv.2023.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/29/2023] [Accepted: 10/08/2023] [Indexed: 10/20/2023]
Abstract
AIMS To investigate the cross-sectional association between deep and superficial diabetic neuropathy, postural impairment assessed by wearable inertial sensors, and the risk of fall among patients with diabetic foot. METHODS Diabetic patients attending a University Podiatric Clinic were evaluated for the presence of deep and superficial peripheral neuropathy in sensory tests. Postural impairment was assessed using a wearable inertial sensor, and the evaluation of balance/gait and risk of fall was determined by the Tinetti Scale and Downton Index, respectively. Glycemic control was measured by glycated haemoglobin concentration and fasting glycaemia. The postural parameters measured were the anteroposterior and medio-lateral sway of the center of mass (CoM) and the sway area (area traveled by the CoM per second). The results were analyzed through a logistic regression model to assess those posture variables mostly significantly associated with neuropathy and risk of fall scales. RESULTS A total of 85 patients were evaluated. Spearman's rank correlation coefficients showed a strong and significant relationship (p < 0.05) between deep diabetic neuropathy assessed by Semmes-Weinstein monofilament, diapason and biothensiometer and postural alterations, whereas no significant correlations between superficial (painful sensitivity) neuropathy and the postural parameters. The sway path of the displacement along the anterior-posterior axis recorded during tests performed with eyes open and feet close together were significantly (p < 0.05) correlated with a poor glycemic (glycated haemoglobin concentration) control and each other with all diabetic neuropathy tests, fall risk scales, muscular weakness, ankle joint limitation and history of ulcers. CONCLUSIONS The results support the existence of a strong association between alterations of the deep somato-sensitive pathway (although depending on the tool used to measure peripheral neuropathy), glycemic control and balance impairments assessed using a wearable sensors. Wearable-based postural analysis might be part of the clinical assessment that enables the detection of balance impairments and the risk of fall in diabetic patients with diabetic peripheral neuropathy.
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Affiliation(s)
- Lorenzo Brognara
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40123, Bologna, Italy
| | | | - Antonio Mazzotti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40123, Bologna, Italy; IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy, 1st Orthopaedic and Traumatologic Clinic.
| | - Elena Artioli
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy, 1st Orthopaedic and Traumatologic Clinic.
| | - Iván Julián-Rochina
- Nursing Department, University of Valencia, 46010, Valencia, Spain; Frailty Research Organized Group, Faculty of Nursing and Podiatry, University of Valencia, 46010, Valencia, Spain.
| | - Omar Cauli
- Nursing Department, University of Valencia, 46010, Valencia, Spain; Frailty Research Organized Group, Faculty of Nursing and Podiatry, University of Valencia, 46010, Valencia, Spain.
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Cibulková N, Daďová K, Mašková K, Busch A, Kobesová A, Vařeková J, Hašpicová M, Matoulek M. Bariatric surgery and exercise: A pilot study on postural stability in obese individuals. PLoS One 2022; 17:e0262651. [PMID: 35030216 PMCID: PMC8759698 DOI: 10.1371/journal.pone.0262651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/03/2022] [Indexed: 11/18/2022] Open
Abstract
This study aimed to analyze the changes in postural stability of individuals with obesity after bariatric surgery, and the effect of three months of regular exercise on the static postural stability. Twenty-two subjects (7 females and 15 males) aged 31 to 68 years (Body mass index 35-55 kg.m-2) completed the study. Participants were divided into two groups: one group participated in an exercise program after the bariatric surgery (n = 10; age 48.9 ± 7.5 years; Body mass index 42 ± 5.6 kg.m-2) while the second group did not exercise at all after bariatric surgery (n = 12; age 44.7 ± 13.6 years, Body mass index 42.6 ± 6.0 kg.m-2). Static postural stability was measured using a Tekscan MobileMat pressure plate before and 4 months after the bariatric surgery. The exercise program included exercising three times a week including: one hour of strengthening, one hour of aerobic group exercise and at least one session of individual exercise at home. There were no significant differences in Center of force sway, Center of force ranges and average speed before and 4 months after bariatric surgery. Also, no effect of exercise was found. Post-pre differences of some parameters were negatively related to age (r from-0.46 to-0.72). Further studies are needed to explore this topic in depth.
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Affiliation(s)
- Natálie Cibulková
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
- Third Department of Internal Medicine, General University Hospital in Prague, Prague, Czech Republic
| | - Klára Daďová
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Kateřina Mašková
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Andrew Busch
- Health and Human Kinetics, Ohio Wesleyan University, Delaware, Ohio, United States of America
| | - Alena Kobesová
- Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jitka Vařeková
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | | | - Martin Matoulek
- Third Department of Internal Medicine, General University Hospital in Prague, Prague, Czech Republic
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Zordão CC, Mendonça Junior ES, Valério PM, Perez CS, Ferro AP, Guirro ECDO. Immediate Effect of Manual Therapy on Tibiotarsal Joint Mobility and Static Balance in Individuals With Diabetes. J Chiropr Med 2022; 20:128-137. [DOI: 10.1016/j.jcm.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 12/25/2022] Open
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Yin L, Qin J, Chen Y, Xie J, Hong C, Huang J, Xu Y, Liu Z, Tao J. Impact of Body Mass Index on Static Postural Control in Adults With and Without Diabetes: A Cross-Sectional Study. Front Endocrinol (Lausanne) 2021; 12:768185. [PMID: 35002958 PMCID: PMC8739700 DOI: 10.3389/fendo.2021.768185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/06/2021] [Indexed: 11/21/2022] Open
Abstract
AIM The objective of this research was to determine the static postural control differences measured from a force platform in Type 2 diabetes mellitus (T2DM) and healthy control groups with different levels of body mass index (BMI), and detect the static postural control difference between T2DM and healthy control groups stratified by different BMI category. This research also explored the relationship of BMI and static postural performance. METHODS We recruited 706 participants with T2DM and 692 healthy controls who were sufficiently matched for age, gender, and BMI in this cross-sectional study. The participants were stratified into three groups by BMI: normal weight, overweight, and obesity. All participants performed two-legged static stance postural control assessment on a firm force platform. The Center of Pressure (CoP) parameters were collected under eyes-open and eyes-closed conditions. Mann-Whitney U test was used to compare the static postural control parameters within each BMI category in both groups. The static postural control parameters among different weight groups were compared by Kruskal-Wallis test, post hoc pair-wise comparison were conducted. Generalized linear model was conducted to examine the association between BMI and static postural control parameters while controlling for confounding factors. RESULTS Healthy control group had statistical difference in most CoP parameters compared to T2DM group based on all BMI categories. Normal weight participants presented significant difference compared with overweight and/or obesity for total track length (TTL) and velocity of CoP displacements in Y direction (V-Y) under eyes-open condition, and for most CoP parameters under eyes-closed condition in both groups. There were statistically significant correlations between BMI and most static postural control parameters under only eyes-closed condition according to the result of generalized linear model. CONCLUSION T2DM patients had impaired static postural control performance compared to healthy controls at all BMI categories. The findings also indicated the association between BMI and static postural control, where higher BMI individuals showed more static postural instability in both T2DM and healthy controls.
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Affiliation(s)
- Lianhua Yin
- Health Management Center, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiawei Qin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Department of Rehabilitation Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
| | - Yannan Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jinjin Xie
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Cuiping Hong
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou, China
| | - Ying Xu
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Zhizhen Liu
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- *Correspondence: Zhizhen Liu, ; Jing Tao,
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Ministry of Education, Fuzhou, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- *Correspondence: Zhizhen Liu, ; Jing Tao,
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Shiferaw WS, Akalu TY, Work Y, Aynalem YA. Prevalence of diabetic peripheral neuropathy in Africa: a systematic review and meta-analysis. BMC Endocr Disord 2020; 20:49. [PMID: 32293400 PMCID: PMC7158034 DOI: 10.1186/s12902-020-0534-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 04/05/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a global health care problem that can impose a substantial economic burden. Diabetic peripheral neuropathy (DPN) is a common microvascular complication of DM that increases the potential for morbidity and disability due to ulceration and amputation. Though there is a significant amount of variation in the primary studies on DM regarding the prevalence of DPN in Africa. Hence, this study was aimed to estimate the overall prevalence of DPN in DM patients in Africa. METHODS PubMed, Scopus, Google Scholar, African Journals OnLine, WHO African Library, and the Cochrane Review were systematically searched online to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines was followed. Heterogeneity across the included studies was evaluated by the inconsistency index (I2). Publication bias was examined by funnel plot and Egger's regression test. The random-effect model was fitted to estimate the pooled prevalence of diabetic peripheral neuropathy among patients in Africa. The meta-analysis was performed using the STATA™ Version 14 software. RESULTS Twenty-three studies which includes 269,691 participants were included in the meta-analysis. The overall pooled prevalence of diabetic peripheral neuropathy was 46% (95% CI:36.21-55.78%). Based on the subgroup analysis, the highest prevalence of diabetic peripheral neuropathy in DM patients was reported in West Africa at 49.4% (95% CI: 32.74, 66.06). CONCLUSION This study revealed that the overall prevalence of diabetic peripheral neuropathy is relatively high in Africa. Hence, DPN needs situation-based interventions and preventive strategies, which are specific to the country. Further meta-analysis is needed to identify associated factors for the occurrence of diabetic peripheral neuropathy.
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Affiliation(s)
- Wondimeneh Shibabaw Shiferaw
- Department of Nursing, Institute of Medicine and College of Health Science, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia
| | - Tadesse Yirga Akalu
- Department of Nursing, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Yeshamble Work
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yared Asmare Aynalem
- Department of Nursing, Institute of Medicine and College of Health Science, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia
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Viseux FJ. The sensory role of the sole of the foot: Review and update on clinical perspectives. Neurophysiol Clin 2020; 50:55-68. [DOI: 10.1016/j.neucli.2019.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/24/2019] [Accepted: 12/24/2019] [Indexed: 12/26/2022] Open
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Ostolin TLVDP, Gonze BDB, Jesus MOD, Arantes RL, Sperandio EF, Dourado VZ. Effects of obesity on postural balance and occurrence of falls in asymptomatic adults. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Previous studies suggested that body weight is a strong predictor for postural balance. High body mass index (BMI) presented an association with increased postural sway. However, it seems controversial since studies reported no difference between obese and control group regarding the position of the center of pressure in static postural balance (PB). Also, there is a lack of investigations about the impact of obesity on PB, free of the confound effect of cardiometabolic risk. Objective: The aim of this study was to evaluate the effects of obesity in static PB and occurrence of falls in asymptomatic adults and older adults over 40 years old. Method: The PB of 624 subjects divided into quartiles for BMI, waist-to-hip ratio, waist-to-height and fat body mass as percentage (%FBM) was assessed with and without vision using a force platform. An MANOVA was used to determine if there were differences between quartiles and a logistic regression analysis adjusted for confounders variables were applied to determine the obesity role in the occurrence of falls. Results: We found weak to moderate bivariate correlations between obesity and static PB, which became non-significant after adjustment. We found significant differences between first and fourth quartiles, especially using %FBM. Obesity was not related to the occurrence of falls since the odds ratio values became non-significant for all the indices of obesity after adjustment. Conclusion: Obesity presents little influence on maintaining static PB and seems not to determine the occurrence of falls among subjects over 40 years old.
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Affiliation(s)
| | | | | | - Rodolfo Leite Arantes
- Universidade Federal de São Paulo, Brazil; Instituto de Medicina Cardiovascular Angiocorpore, Brazil
| | - Evandro Fornias Sperandio
- Universidade Federal de São Paulo, Brazil; Instituto de Medicina Cardiovascular Angiocorpore, Brazil
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Ohlendorf D, Mickel C, Filmann N, Wanke EM, Groneberg DA. Standard values of the upper body posture and postural control: a study protocol. J Occup Med Toxicol 2016; 11:34. [PMID: 27429641 PMCID: PMC4947251 DOI: 10.1186/s12995-016-0122-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 06/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background Decisions on orthopedic interventions on upper body posture and its control have usually resulted from comparisons with the healthy state. Therefore, practitioners as well as scientists in human movement science or orthopedics need access to such kind of data which are patient-centered and well measured. Until now, these data have been missing concerning upper body posture as well as postural control and their control. That is why the aim of the current project is to measure these data with healthy participants across the lifespan. Results For standard value determination tolerance range and confidence intervals will be calculated. In addition, Pearson- or Spearman-Rank correlations will be used as well as two-sample-t-tests or Mann-Whitney-U-tests for specific group differences. All tests will be two-sided with the level of significance of 5 %. Discussion This project aims at improving classifications in adaptations of upper body posture and postural control. Measured standard values have not been determined before to this extent. Therefore, interventional effects may become better quantifiable and justiciable.
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Affiliation(s)
- Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt/Main, 60590 Germany
| | - Christoph Mickel
- Institute of Sport Sciences, Goethe-University Frankfurt/Main, Ginnheimer Landstraße 39, Frankfurt/Main, 60487 Germany
| | - Natalie Filmann
- Institute of Biostatistics and Mathematical Modeling, Goethe-University, Frankfurt/Main, Theodor-Stern-Kai 7, Building 11, Frankfurt/Main, 60590 Germany
| | - Eileen M Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt/Main, 60590 Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9A, Frankfurt/Main, 60590 Germany
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