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Komalasari DR, Vongsirinavarat M, Hiengkaew V, Nualnim N. Balance performance, falls-efficacy and social participation in patients with type 2 diabetes mellitus with and without vestibular dysfunction. PeerJ 2024; 12:e17287. [PMID: 38766481 PMCID: PMC11102735 DOI: 10.7717/peerj.17287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/02/2024] [Indexed: 05/22/2024] Open
Abstract
Background The performance of balance is an important factor to perform activities. The complications of type 2 diabetes mellitus (T2DM), especially vestibular dysfunction (VD), could decrease balance performance and falls-efficacy (FE) which consequently impacts social participation and quality of life (QoL). Purpose This study aimed to compare balance performance, FE, social participation and QoL between individuals with T2DM with and without VD. Methods The participants comprised 161 T2DM with VD and 161 without VD. Three clinical tests used for confirming VD included the Head Impulse Test (HIT), the Dix Hallpike Test (DHT) and the Supine Roll Test (SRT). The scores of static and dynamic balances, FE, social participation and QoL were compared between groups. Results The balance performance, FE, social participation and QoL were lower in the group with VD. The number of patients who had severe social restriction was higher in T2DM with VD than without VD (58.4% vs 48.4%). Moreover, all domains of QoL (physical, psychological, social relationships and environmental) were lower in T2DM with VD than without VD. Conclusion The presence of VD in T2DM patients was associated with decreased physical balance performances and increased social and QoL disengagement. Comprehensive management related to balance and FE, as well as the monitoring to support social participation and QoL, should be emphasized in patients with T2DM with VD.
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Affiliation(s)
| | | | - Vimonwan Hiengkaew
- Physical Therapy, Mahidol University, Salaya, Phuttamonthon, Nakhon Pathom, Thailand
| | - Nantinee Nualnim
- Physical Therapy, Mahidol University, Salaya, Phuttamonthon, Nakhon Pathom, Thailand
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2
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Guerrero K, Umagat A, Barton M, Martinez A, Ho KY, Mann S, Hilgenkamp T. The effect of a telehealth exercise intervention on balance in adults with Down syndrome. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:385-393. [PMID: 36585748 DOI: 10.1111/jar.13068] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND People with Down syndrome often present with balance deficits, which compromise safety during daily activity. While evidence shows that exercise can improve balance in the Down syndrome population, it is unclear if a telehealth method will elicit similar benefits. We aimed to examine the effects of a virtual exercise program on balance in adults with Down syndrome. METHODS Eighteen low-active participants with Down syndrome completed a 12-week telehealth exercise program based on the Mann Method. Balance testing took place before and after the intervention, which included: TUG, MCTSIB, FICSIT-4, and FRT. This study was registered as a clinical trial on ClinicalTrials.gov, identifier: NCT04647851. RESULTS Significant improvement was seen in the TUG (p = .043), FICSIT-4 (p = .019) and FRT (p = .019). All participants achieved maximum scores on the MCTSIB in pre- and post-testing. CONCLUSIONS Balance in low-active adults with Down syndrome significantly improved following the telehealth exercise program, which we attribute to the tailored exercises that address visual/vestibular deficits and hip muscle weakness.
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Affiliation(s)
- Kristina Guerrero
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Alexandria Umagat
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Mark Barton
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Andrew Martinez
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Kai-Yu Ho
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Sarah Mann
- Mann Method PT and Fitness, Arvada, Colorado, USA
| | - Thessa Hilgenkamp
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
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3
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Gialanella B, Comini L, Prometti P. Determinants of improvement in functional abilities in peripheral neuropathy patients undergoing rehabilitation: the role of Berg Balance Scale items. Acta Neurol Belg 2023; 123:173-179. [PMID: 34608595 DOI: 10.1007/s13760-021-01806-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This prospective observational cohort study aimed to verify whether single Berg Balance Scale (BBS) items were important determinants of improvement in functional abilities in patients with peripheral neuropathy (PN). METHODS Data were collected in 75 older patients with PN performing a standard motor rehabilitation program. Backward stepwise multiple regression analyses were performed to identify determinants of outcome measures. Gain in total and motor Functional Independence Measure (FIM) and gain in motor-FIM areas were the outcome measures. RESULTS Among BBS items, at the end of rehabilitation, the score was higher in "sitting unsupported" (3.94 ± 0.22) and lower in "standing on one foot" (1.18 ± 1.06). The gain was higher in "standing to sitting" (1.02 ± 0.67) and "standing unsupported" (1.00 ± 1.00), and lower in "sitting unsupported" (0.22 ± 0.60) and "standing on one foot" (0.65 ± 0.77). "Standing unsupported" was the only determinant of gain in motor-FIM (beta - 0.36, p = 0.002) and gain in self-care (beta - 0.37, p = 0.002). The R2 value of the models was 0.13 and 0.14, respectively. No independent variable was a determinant of gain in total-FIM. CONCLUSIONS The study shows that "unsupported standing" is an important determinant of results of ADL rehabilitation in PN patients and indicates that ability to stand without support for a fairly long time is an essential requirement to achieve with rehabilitation higher gain levels in functional abilities in PN patients.
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Affiliation(s)
- Bernardo Gialanella
- Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit for Recovery and Functional Rehabilitation of the Institute of Lumezzane, Via G Mazzini, 129, 25065, Lumezzane, Brescia, Italy.
| | - Laura Comini
- Istituti Clinici Scientifici Maugeri IRCCS, Scientific Direction of the Institute of Lumezzane, Brescia, Italy
| | - Paola Prometti
- Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit for Recovery and Functional Rehabilitation of the Institute of Lumezzane, Via G Mazzini, 129, 25065, Lumezzane, Brescia, Italy
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Kalu ME, Dal Bello-Haas V, Griffin M, Boamah SA, Harris J, Zaide M, Rayner D, Khattab N, Bhatt V, Goodin C, Song JW(B, Smal J, Budd N. Physical mobility determinants among older adults: a scoping review of self-reported and performance-based measures. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2153303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Michael E. Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila A. Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Vidhi Bhatt
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | | | - Justin Smal
- Manitoulin Physio Centre, M'Chigeeng, Canada
| | - Natalie Budd
- The Arthtitis and Sports Medicine Centre, Ancaster, Canada
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5
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Silva-Viguera MC, García-Romera MC, López-Izquierdo I, De-Hita-Cantalejo C, Sánchez-González MC, Bautista-Llamas MJ. Contrast Sensitivity Assessment in Early Diagnosis of Diabetic Retinopathy: A Systematic Review. Semin Ophthalmol 2022; 38:319-332. [PMID: 36047470 DOI: 10.1080/08820538.2022.2116289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
INTRODUCTION The purpose of this systematic review was to study whether contrast sensitivity assessment in people with diabetes could be a reliable test in early detection of diabetic retinopathy. A systematic search based on population, intervention, comparison, and outcome strategy was performed. METHODS PubMed, Scopus, and Web of Science were searched for English articles of human patients with type 1 and type 2 diabetes and contrast sensitivity measurements as domain studied. RESULTS Twentyone comparative cross-sectional studies were included. All of them showed significant loss of contrast sensitivity in people with diabetes and diabetic retinopathy regarding control patients of the same age, regardless of the method used. However, those without diabetic retinopathy, involve a loss of contrast sensitivity, although not always significant. CONCLUSION Changes in contrast sensitivity suggest that there is damage to the retina prior to the vascular ones and that they could be detected by this test.
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Affiliation(s)
- María-Carmen Silva-Viguera
- Department of Physics of Condensed Matter, Optics Area. Vision Research Group (CIVIUS), University of Seville, Seville, Spain
| | - Marta-C García-Romera
- Department of Physics of Condensed Matter, Optics Area. Vision Research Group (CIVIUS), University of Seville, Seville, Spain
| | - Inmaculada López-Izquierdo
- Department of Physics of Condensed Matter, Optics Area. Vision Research Group (CIVIUS), University of Seville, Seville, Spain
| | - Concepción De-Hita-Cantalejo
- Department of Physics of Condensed Matter, Optics Area. Vision Research Group (CIVIUS), University of Seville, Seville, Spain
| | - María Carmen Sánchez-González
- Department of Physics of Condensed Matter, Optics Area. Vision Research Group (CIVIUS), University of Seville, Seville, Spain
| | - María-José Bautista-Llamas
- Department of Physics of Condensed Matter, Optics Area. Vision Research Group (CIVIUS), University of Seville, Seville, Spain
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Mullin RL, Smith R, Wood S, Swampillai A, Afridi S. Reliability of functional outcome measures in adults with neurofibromatosis 2. SAGE Open Med 2022; 10:20503121221118996. [PMID: 36003079 PMCID: PMC9393935 DOI: 10.1177/20503121221118996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022] Open
Abstract
Objective: To determine inter- and intra-rater reliability of functional performance outcome measures in people with neurofibromatosis 2. To ascertain how closely objective and subjective measures align. Methods: Twenty-nine people with neurofibromatosis 2 were recorded performing the modified clinical test of sensory integration and balance, four square step test and modified nine-hole peg tests. Three raters scored each measure to determine inter-rater reliability. One rater scored the measures a second time to determine intra-rater reliability. Participants also completed a disease-specific quality of life questionnaire and dynamic visual acuity testing. Results: Inter-rater and intra-rater reliability scores (intra-class correlation coefficient) were excellent for all tests (intra-class correlation coefficient r ⩾ 0.9). The four square step test correlated with perceived walking challenges and modified clinical test of sensory integration and balance correlated with perceived balance challenges in a neurofibromatosis 2 quality of life patient report outcome measure. Conclusion: The modified clinical test of sensory integration and balance, four square step test and modified nine-hole peg tests are potentially useful measures for monitoring neurofibromatosis 2.
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Affiliation(s)
- Rebecca Louise Mullin
- National Centre for Neurofibromatosis, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Physiotherapy, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Rebecca Smith
- National Centre for Neurofibromatosis, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Physiotherapy, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Susan Wood
- National Centre for Neurofibromatosis, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Angela Swampillai
- National Centre for Neurofibromatosis, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Shazia Afridi
- National Centre for Neurofibromatosis, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Zilbershlag Y, Ravitz-Ron K, Engel-Yeger B. The Role of Altered Sensory Processing and Its Association with Participation in Daily Activities and Quality of Life among Older Adults in the Community. Occup Ther Health Care 2022; 37:230-247. [PMID: 35034550 DOI: 10.1080/07380577.2022.2025552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To identify variables that contribute to fall risk in older adults, this study examined the relationship between fall risk, sensory processing, participation in daily activities, and quality of life (QoL). Of the 123 participants, those at high-risk were significantly less able to register sensory input and had increased sensory sensitivity, restricted participation and overall lower QoL. Altered sensory processing was related with risk of falling. Additionally, both sensory process and fall risk were subsequently related with lower daily participation and, together, were related with lower QoL. Thus, sensory processing, participation and QoL assessments need to be included in occupational therapy evaluations and interventions for fall risk among older adults.
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Affiliation(s)
- Yael Zilbershlag
- Department of Occupational Therapy, Faculty of Health Allied Professions, Ono Academic College, Kiryat Ono, Israel
| | - Keren Ravitz-Ron
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Batya Engel-Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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8
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Khan N, Ahmad I, Noohu MM. Association of disease duration and sensorimotor function in type 2 diabetes mellitus: beyond diabetic peripheral neuropathy. Somatosens Mot Res 2020; 37:326-333. [PMID: 33028136 DOI: 10.1080/08990220.2020.1830757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE The aim of the study is to assess association of the duration of diabetes and vibration, proprioception, muscle strength, reaction time and balance measures in people with type 2 diabetes mellitus (DM) without peripheral neuropathy. METHODS Forty-seven type 2 diabetics without peripheral neuropathy and 23 healthy controls were recruited for the study. Patients with type 2 DM were further classified into 23 patients who suffered from diabetes for less than 5 years (<5yrDM) and 24 patients who had diabetes for 5 years and above (≥5yrDM). All participants were assessed for Michigan neuropathy screening instrument (MNSI), vibration perception threshold (VPT), proprioception, muscles strength, centre of pressure (COP) range, COP sway and reaction time. RESULTS ≥5yrDM patients were found to significantly differ from healthy control in MNSI score (p ≤ 0.013), VPT score (p ≤ 0.002), reaction time (p ≤ 0.018), COP range (p ≤ 0.005) and COP sway (p ≤ 0.027). A significant difference was found only in reaction time (p < 0.002) except in the back direction (p = 0.089), and COP range (p ≤ 0.016) except in the front (p = 0.101) and right direction (p = 0.085) between <5yrDM patients and healthy controls. CONCLUSIONS ≥5yrDM patients exhibit a subtle deterioration in VPT, reaction time, and balance measure while <5yr DM patients were impaired only in COP range and reaction time when compared with healthy control.
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Affiliation(s)
- Neha Khan
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia Central University, New Delhi, India
| | - Irshad Ahmad
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia Central University, New Delhi, India.,Department of Physiotherapy, Manav Rachna International Institute of Research and Studies, Faridabad, India
| | - Majumi M Noohu
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia Central University, New Delhi, India
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9
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Lučarević J, Gaunaurd I, Clemens S, Belsky P, Summerton L, Walkup M, Wallace SP, Yokomizo L, Pasquina P, Applegate EB, Schubert MC, Gailey RS. The Relationship Between Vestibular Sensory Integration and Prosthetic Mobility in Community Ambulators With Unilateral Lower Limb Amputation. Phys Ther 2020; 100:1333-1342. [PMID: 32399552 DOI: 10.1093/ptj/pzaa091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 09/17/2018] [Accepted: 02/11/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The modified Clinical Test of Sensory Interaction and Balance (mCTSIB) is used to clinically assess vestibular sensory integration (VSI), the process by which the central nervous system integrates vestibular afference to maintain balance. The rate and effects of impaired VSI (IVSI) on prosthetic mobility in people with lower limb amputation (LLA) is unknown. The objective of this study was to use the mCTSIB to classify VSI in active community ambulators with LLA and to examine the relationship between IVSI and prosthetic mobility, as measured by the Component Timed Up and Go (cTUG) test. METHODS This was a cross-sectional study with a convenience sample of 130 community ambulators with unilateral LLA. Classification of VSI was determined based on a time-based pass/fail mCTSIB performance. Participants were classified as having normal sensory integration (NSI) if they could balance for 30 seconds in every mCTSIB condition. Participants who failed condition 4 exclusively were classified as IVSI. Prosthetic mobility, as measured by the cTUG, was compared between NSI and IVSI groups. RESULTS Of the 130 participants, 29 (22%) were classified as IVSI and 95 (73%) were classified as having NSI. Prosthetic mobility significantly differed between IVSI and NSI groups, with IVSI participants performing all components of the cTUG significantly slower. Medium to large effect sizes were found between groups during cTUG. CONCLUSIONS These results suggest that 1 in 5 community ambulators with LLA have IVSI, with associated limitations in balance confidence and prosthetic mobility. IMPACT The ability to integrate vestibular information was found to have a strong relationship with prosthetic mobility in active community ambulators with LLA, especially with performing a 180-degree step turn. Physical therapists can use the mCTSIB to classify sensory integration during prosthetic rehabilitation and develop an appropriate balance intervention. LAY SUMMARY Active adults with LLA can use information from their senses to maintain their standing balance. Adults with LLA who have difficulty balancing on foam with closed eyes were slower to get in and out of a chair, walk, and perform a 180-degree step turn.
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Affiliation(s)
- Jennifer Lučarević
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Coral Gables, Florida; and California State University Dominguez Hills, Department of Orthotics and Prosthetics, Carson, California
| | - Ignacio Gaunaurd
- Miami Veterans Affairs Healthcare System, Miami, Florida; and Department of Physical Therapy, Miller School of Medicine, University of Miami
| | - Sheila Clemens
- Department of Physical Therapy, Miller School of Medicine, University of Miami; and Department of Physical Therapy, Florida International University, Miami, Florida
| | - Paulina Belsky
- Department of Physical Therapy, Miller School of Medicine, University of Miami
| | - Lauren Summerton
- Department of Physical Therapy, Miller School of Medicine, University of Miami
| | - Melody Walkup
- Department of Physical Therapy, Miller School of Medicine, University of Miami
| | | | - Lori Yokomizo
- Department of Physical Therapy, Miller School of Medicine, University of Miami
| | - Paul Pasquina
- Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - E Brooks Applegate
- Department of Educational Leadership, Research and Technology, Western Michigan University, Kalamazoo, Michigan
| | - Michael C Schubert
- Department of Otolaryngology Head Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert S Gailey
- Department of Physical Therapy, Miller School of Medicine, University of Miami, 5915 Ponce de Leon Boulevard, Coral Gables, FL 33146 (USA)
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10
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Kraiwong R, Vongsirinavarat M, Hiengkaew V, von Heideken Wågert P. Effect of Sensory Impairment on Balance Performance and Lower Limb Muscle Strength in Older Adults With Type 2 Diabetes. Ann Rehabil Med 2019; 43:497-508. [PMID: 31499604 PMCID: PMC6734027 DOI: 10.5535/arm.2019.43.4.497] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/22/2019] [Indexed: 12/23/2022] Open
Abstract
Objective To compare balance performance and lower limb muscle strength between older adults with type 2 diabetes mellitus (DM), with and without sensory impairments and non-DM groups. Influence of a number of sensory impairments, and muscle strength on balance performance were explored. Methods Ninety-two older adults with and without type 2 DM, were examined relative to visual function with the Snellen chart, Melbourne Edge test, and Howard-Dolman test, vestibular function with the modified Romberg test, proprioception of the big toe, and diabetic peripheral neuropathy with the Michigan Neuropathy Screening Instrument. Balance performances were evaluated with the Romberg test, Functional Reach Test (FRT), and Timed Up and Go test (TUG). Strength of knee and ankle muscles was measured. Results FRT of type 2 DM groups with at least two sensory impairments, was lower than the non-DM group (p<0.05). TUG of all DM groups, was worse than the non-DM group (p<0.01). Lower limb muscle strength of type 2 DM groups with two and three sensory impairments, was weaker than non-DM group (p<0.05). Regression analysis showed that type 2 DM with three sensory impairments, ankle dorsiflexors strength, and age were influential predictors of TUG. Conclusion There were significant differences, of muscle strength and balance performance among groups. Poorer balance and reduced lower limb strength were marked in older adults with type 2 DM, even ones without sensory impairment. Muscle weakness seemed to progress, from the distal part of lower limbs. A greater number of sensory impairments, weaker dorsiflexors, and advanced age influenced balance performance.
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Affiliation(s)
- Ratchanok Kraiwong
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | | | - Vimonwan Hiengkaew
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
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11
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Fear of Falling and Balance Confidence in Older Adults With Type 2 Diabetes Mellitus: A Scoping Review. Can J Diabetes 2018; 42:664-670. [DOI: 10.1016/j.jcjd.2018.02.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/21/2018] [Indexed: 02/01/2023]
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12
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Vafaei A, Aubin M, Buhrmann R, Kergoat M, Aljied R, Freeman EE. Interaction Between Visual Acuity and Peripheral Vascular Disease with Balance. J Am Geriatr Soc 2018; 66:1934-1939. [DOI: 10.1111/jgs.15490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/17/2018] [Accepted: 05/17/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Afshin Vafaei
- Health SciencesLakehead UniversityThunder Bay Ontario Canada
| | - Marie‐Josée Aubin
- Department of OphthalmologyUniversité de MontréalMontreal Canada
- Maisonneuve‐Rosemont Hospital Research CentreMontreal Canada
| | - Ralf Buhrmann
- Department of OphthalmologyUniversity of OttawaOttawa Canada
| | - Marie‐Jeanne Kergoat
- Centre de RechercheInstitut Universitaire de Gériatrie de MontréalMontreal Canada
- Department of MedicineUniversité de MontréalMontreal Canada
| | - Rumaisa Aljied
- School of Epidemiology and Public HealthUniversity of OttawaOttawa Canada
| | - Ellen E. Freeman
- Department of OphthalmologyUniversité de MontréalMontreal Canada
- Maisonneuve‐Rosemont Hospital Research CentreMontreal Canada
- Department of OphthalmologyUniversity of OttawaOttawa Canada
- School of Epidemiology and Public HealthUniversity of OttawaOttawa Canada
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Hewston P, Deshpande N. Head and Trunk Control While Walking in Older Adults with Diabetes: Effects of Balance Confidence. J Mot Behav 2017; 50:65-72. [PMID: 28350286 DOI: 10.1080/00222895.2017.1283291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Investigations of gait in older adults with diabetes mellitus (DM) have been primarily focused on lower limb biomechanical parameters. Yet, the upper body accounts for two thirds of the body's mass, and head and trunk control are critical for balance. The authors examined head and trunk control during self-selected comfortable, fast, and dual-task walking and the relationship between balance confidence and potential head-trunk stiffening strategies in older adults with DM without diagnosed diabetic peripheral neuropathy (DPN). Twelve older adults with DM without diagnosed DPN (DM group) and 12 without DM (no-DM group) were recruited. Walking speed, peak-to-peak head and trunk roll displacement, head and trunk roll velocity, and head-trunk correlation were measured while walking at a self-selected comfortable or fastest possible speed with or without a secondary cognitive task. The Activities-specific Balance Confidence scale measured balance confidence. Subtle group differences in axial segmental control (lower trunk roll velocity; higher head-trunk correlation) were apparent in older adults with DM even in the absence of DPN. Balance confidence was 19% lower in the DM group than in the no-DM group, and partially explained (34%) the group difference in head-trunk stiffening. These results emphasize the need for proactive monitoring of postural control and balance confidence before the onset of DPN.
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Affiliation(s)
- Patricia Hewston
- a School of Rehabilitation Therapy , Queen's University , Kingston , Ontario , Canada
| | - Nandini Deshpande
- a School of Rehabilitation Therapy , Queen's University , Kingston , Ontario , Canada
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14
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Hewston P, Deshpande N. The Short Version of the Activities-Specific Balance Confidence Scale for Older Adults with Diabetes-Convergent, Discriminant and Concurrent Validity: A Pilot Study. Can J Diabetes 2017; 41:266-272. [PMID: 28268190 DOI: 10.1016/j.jcjd.2016.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/07/2016] [Accepted: 10/13/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The short version of the Activities-Specific Balance Confidence Scale (ABC-6) is advantageous in busy clinical or research settings because it can be administered in less time than the original 16-item Activities-Specific Balance Confidence Scale (ABC-16). This pilot study examined the convergent, discriminant and concurrent validity of the ABC-6 in older adults with diabetes mellitus with and without diagnosed diabetic peripheral neuropathy (DPN). METHODS Thirty older adults (aged ≥65) were age- and sex-matched in 3 groups: 10 with diabetes (DM group), 10 with diagnosed DPN (DPN group) and 10 without diabetes (no-DM group). Balance confidence was quantified by the ABC-16, which includes the ABC-6. Potential correlates were evaluated in physical and psychological domains. RESULTS The ABC-6 and ABC-16 balance confidence scores were strongly correlated (r=0.969; p<0.001; convergent validity). The ABC-6 revealed significant differences in balance confidence between the no-DM and the DM groups (p<0.001; discriminant validity), whereas the ABC-16 did not (p>0.05). The ABC-6 was moderately, but significantly, correlated with physical activity level (r=0.528; p=0.017), mobility (r=-0.520; p=0.027), balance (r=0.633; p=0.003), and depressive symptoms (r=-0.515; p=0.020) in the DM study groups (concurrent validity). CONCLUSIONS The ABC-6 and ABC-16 had excellent convergent validity, and both ABC scales had similar concurrent validity. However, the ABC-6 was more sensitive in detecting subtle differences in balance confidence in older adults with diabetes without diagnosed DPN than the ABC-16. Overall, this pilot study provided evidence of the validity of the ABC-6 in older adults with diabetes. Further exploration involving a larger sample size is recommended to confirm these findings.
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Affiliation(s)
- Patricia Hewston
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Nandini Deshpande
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.
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Falls and Balance Impairments in Older Adults with Type 2 Diabetes: Thinking Beyond Diabetic Peripheral Neuropathy. Can J Diabetes 2016; 40:6-9. [DOI: 10.1016/j.jcjd.2015.08.005] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/05/2015] [Accepted: 08/06/2015] [Indexed: 02/07/2023]
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