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Role of sensory feedback in postural control of the patients with diabetic neuropathy

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Background/Purpose

Impaired balance is prevalent in patients with type II diabetes mellitus (T2DM). The aim of the current study was to evaluate the role of sensory information in these patients.

Methods

Stabilogram-diffusion analysis was utilized to categorize the balance into local and central control modes based on the center of pressure (CoP) data acquired from quiet standing tests of 36 patients with T2DM and 20 healthy individuals. Local control was considered the efforts of muscles to stiffen the joints. Central control was the mode in which sensory information is used. Open- and closed-eye conditions were added to detect other sensory sources during the standing. Traditional linear measures of stability were also calculated for anterior–posterior and mediolateral directions.

Results

Results showed that sway area, pathlength, and maximum velocity of the CoP are higher in the T2DM group (p < 0.001) in open-eye condition, but they did not change in eyes closed (p > 0.158). Both the local and central control mechanisms can cause postural instability in AP direction in patients with T2DM (p < 0.017). Contrarily, diabetes had no effect on the ML direction (p > 0.051). Patients with T2DM had a significant delay (about 225 ms greater than the controls) in the use of sensory information reflected in the AP direction outputs (p < 0.009).

Conclusion

The patients with T2DM had poorer stability due to the delayed use of the sensory information. Diabetic postural stability was not fully provided in comparison with the healthy people even with using the sensory information. Elimination of the visual feedback led to reduced postural balance in these patients.

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Data Availability

The data are available from the corresponding author.

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Acknowledgements

The authors would like to thank this study's participants and the Movement Disorders lab of Tarbiat Modares University.

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Authors and Affiliations

  1. Faculty of Biomedical Engineering, Sahand University of Technology, Tabriz, Iran

    Alireza Reisi & Alireza Hashemi-Oskouei

  2. Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

    Mohammed N. Ashtiani & Farid Bahrpeyma

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  1. Alireza Reisi
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  2. Alireza Hashemi-Oskouei
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Correspondence to Farid Bahrpeyma.

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Ethical clearance

The Ethical Committee of Tabriz University of Medical Sciences approved the study (code: IR.TBZMED.REC.1397.655). All procedures were performed according to the Declaration of Helsinki. All participants signed informed consent forms before participating in the study. Informed Consent Informed consent was obtained from all participants included in the study.

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Reisi, A., Hashemi-Oskouei, A., Ashtiani, M.N. et al. Role of sensory feedback in postural control of the patients with diabetic neuropathy. Int J Diabetes Dev Ctries 44, 77–83 (2024). https://doi.org/10.1007/s13410-023-01200-9

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