Spectral characteristics of postural sway in diabetic neuropathy patients participating in balance training

Journal of Diabetes & Metabolic Disorders

Hamed Ghomashchi⁴  Mansureh Karimzadeh³  Ali Esteki²  Farid Bahrpeyma¹  Hoda Salsabili¹ 

[1] Department of Physical Therapy, Tarbiat Modares University (School of medical Sciences), Tehran, Iran;Department of Biomedical Engineering, Shahid Beheshti University, Tehran, Iran;Department of Pre School education, University of Social Welfare and Rehabilitation, Tehran, Iran;Faculty of Industrial and Mechanical Engineering, Islamic Azad University, Qazvin Branch, Qazvin, Iran

关键词: Postural sway;    Visual feedback;    Total frequency power;    Spectral characteristic;    Balance training;    Diabetic neuropathy;   

Others  :  806961
DOI  :  10.1186/2251-6581-12-29

 received in 2012-08-09, accepted in 2013-06-12,  发布年份 2013

【 摘 要 】

Background

The aim of the present study is to have a detailed frequency analysis about the effect of balance training with respect to reactive movement strategies and sensory strategies in type 2 diabetic neuropathy (DN) patients. Also understand changes in the role of each postural subsystem for controlling quiet standing after balance training.

Methods

A group of 19 patients were included in the quasi experimental, time- series study. Total frequency power, 99% power frequency, centroidal frequency and frequency spectrum in the intervals between 0.01-0.1, 0.1-0.5, 0.5-1 Hz and 1-3 Hz are reported. The training protocol consisted two patterns of limits of stability trainings, three approaches in weight shifting trainings and one stable standing practice on the biodex stability system. Results: Repeated measure ANOVA analysis and the LSD test indicated significant differences for the eyes open ML- frequency power and ML-FFT sway power within low-medium (0.1-0.5 HZ) frequencies.

Conclusions

Decrease in postural sway at low-medium frequencies showed lower reliance on vestibular system. Also, better controlling hip muscles after balance training relieve DN patients’ requirement to more exploratory sway as a compensatory strategy and showed better balance performance after balance training in DN patients.

Trial registration

UMIN-CTR Search Clinical Trials: UMIN000004485.

【 授权许可】

   
2013 Salsabili et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Nashner LM, McCollum G: The organization of human postural movements: A formal basis and experimental synthesis. Behav Brain Sci 1985, 8:135-172.
• [2]Yamamoto R, Kinoshita T, Momoki T, Aria T, Okamura A, Hirao K, Sekihara H: Postural sway and diabetic peripheral neuropathy. Diabetes Res Clin Pract 2001, 52:213-221. PMID: 11323091
• [3]Boucher P, Bard C, Teasdale N, Fleury M, Courtemanche R: Postural stability in diabetic polyneuropathy. Diabetes Care 1995, 18:638-645. PMID: 8586001
• [4]Horak FB, Nashner LM, Diener HC: Postural strategies associated with somato-sensory and vestibular loss. Exp Brain Res 1990, 82:167-177. PMID: 2257901
• [5]Bonnet C, Carello C, Turvey MT: Diabetes and postural stability: Review and Hypotheses. J Mot Behav 2009, 41:172-190. PMID: 19201687
• [6]Horak FB, Dickestein R, Peterka RJ: Diabetic neuropathy and surface sway-referencing disrupt somatosensory information for postural stability in stance. Somatosens Mot Res 2002, 19:316-326. PMID: 12590833
• [7]Ahmmed AU, Mackenzie IJ: Postural changes in diabetes mellitus. J Laryngol Otol 2003, 117:358-364. PMID: 12803785
• [8]Uccioli L, Giacomini P, Monticone G, Magrini A, Durols A, Bruno E, Parisi L, Di Grilamo S, Menzinger G: Body sway in diabetic neuropathy. Diabetic care 1995, 18:339-344. PMID: 7555477
• [9]Giacomini P, Bruno E, Monticone G, Digirolamo S, Magrini A, Parisi L: Postural rearrangement in IDDM patients with peripheral neuropathy. Diabetic Care 1996, 19:372-374. PMID: 8729163
• [10]Dickestein R, Shupert CL, Horak FB: Fingertip touch improves postural stability in patients with peripheral neuropathy. Gait Posture 2001, 14:238-247. PMID: 11600327
• [11]Lafond D, Corriveau H, Prince F: Postural control mechanisms during quiet standing in patients with diabetic sensory neuropathy. Diabetes Care 2004, 17:173-178. PMID: 14693985
• [12]Horak FB, Hlavacka F: Somatosensory loss increases vestibulospinal sensitivity. J Neurophysiol 2001, 86:575-585. PMID: 11495933
• [13]Allet L, Armand S, de Bie RA, Golay A, Monnin D, Aminian K, Staal JB, de Bruin ED: The gait and balance of patients with diabetes can be improved: a randomized controlled trial. Diabetologia 2010, 53:458-466. PMID: 19921145
• [14]Morrison S, Colberg SR, Mariano M, Parson HK, Vinik AI: Balance training reduces falls risk in older individuals with type 2 diabetes. Diabetes Care 2010, 33:748-750. PMID: 20097781
• [15]Richardson JK, Sandman D, Vela S: A focused exercise regimen improves clinical measures of balance in patients with peripheral neuropathy. Arch Phys Med Rehabil 2001, 82:205-209. PMID: 11239311
• [16]Slasabili H, Bahrpeyma F, Forogh B, Rajabali S: Dynamic stability training improves standing balance control in neuropathic patients with type 2 diabetes. J Rehabil Res Dev 2011, 48(7):775-786.
• [17]Horak FB: Postural orientation and equilibrium: What do we need to know about neural control of balance to prevent falls? Age Aging 2006, 3(Suppl 2):ii7-ii11. PMID: 16926210
• [18]Oppenheim U: Kohen_Raz R, Alex D, Kohen_Raz A, Azarya M: postural characteristics of diabetic neuropathy. Diabetes Care 1999, 22:328-333. PMID: 10333953
• [19]Stergiou N: Innovative analyses of human movement. Champaign: Human Kinetics; 2004.
• [20]DeWit G: Optic versus vestibular and properoceptive impulses, measured by posturography. Agressologie 1972, 13:79-82. PMID: 4538702
• [21]Taguchi K: Spectral analysis of the movement of the center of gravity in vertiginous and ataxic patients. Agessologie 1978, 19:69-70. PMID: 727365
• [22]Patat A, Foulhoux P, Klein MJ: Residual effects on the equilibrium of three hypnotics (loprazolam, flunitrazepam, triazolam) assessed by spectrum analysis of postural oscillations. Therapie 1986, 41:443-447. PMID:2880405
• [23]Ferdjallah M, Harris GF, Wertsch JJ: Instantaneous spectral characteristics of postural stability, using time-frequency analysis. In Proceedings of the 19th Annual Conference of the IEEE Engineering in Medicine and Biology 1997, 19:1675-1678.
• [24]Laughlin PJ, Redfern MS: Spectral analysis of visually induced postural sway in healthy elderly young subjects. IEEE Trans Neural Syst Rehabil Eng 2001, 9:24-30. PMID: 11482360
• [25]Tankisi H, Pugdahl K, Fuglsang-Fredriksen A, Johnsen B, de Carvalho M, Fawcett PRW, Labarre-Vila A: Pathophysiology inferred from electro diagnostic nerve tests and classification of polyneuropathies. Suggested guidelines. Clin Neurophysiol 2005, 116:1571-1580. PMID: 15907395
• [26]Valk GD, Grootenhuis PA, van Eijk JTM, Bouter LM: Methods for assessing diabetic polyneuropathy: validity and reproducibility of the measurement of sensory symptom severity and nerve function tests. Diabetes Res Clin Pract 2000, 47:87-96. PMID: 10670907
• [27]Winter DA: Human Balance and posture control during standing and walking. Gait Posture 1995, 3:193-214.
• [28]Lin D, Seol H, Nussbaum MA, Madigan ML: Reliability of Cop- based postural sway measures and age- related differences. Gait Posture 2008, 28:337-342. PMID: 18316191
• [29]Prieto TE, Myklebust JB, Hoffmann RG, Lovett EG, Myklebust BM: Measures of postural steadiness: differences between healthy young and elderly adults. IEEE Trans Biomed Eng 1996, 43:956-966.
• [30]Kim JW, et al.: Sex differences in the postural sway characteristics of young and elderly subjects during quiet natural standing. Geriatr Gerontol Int 2010, 10:191-198.
• [31]Cohen J: Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Erlbaum associates; 1988.
• [32]Golomer E, Cremieux J, Dupui P, Isableu B, Ohlmann T: Visual contribution to self-induced body sway frequencies and visual perception of male professional dancers. Neurosci Lett 1999, 267:189-192.
• [33]Kim BJ, Robinson CJ: Effects of diabetic neuropathy on body sway and slip perturbation detection in older population. Int J Occup Saf Ergon 2006, 12:241-254. PMID: 16984784
• [34]Maki BE, Holliday PJ, Topper AK: A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994, 49:M72-M84. PMID: 8126355
• [35]Nagy E, Feher-Kiss A, Barnai M, Domja’n-Preszner A, Angyan L, Horvath G: Postural control in elderly subjects participating in balances Training. Eur J Appl Physiol 2007, 100:97-104. PMID: 17333243
• [36]Priplata AA, Patritti BL, Niemi JB, Hughes R, Gravelle DC, Lipstiz LA, et al.: Noise-enhanced balance control with diabetes and patients with stroke. Ann Neurol 2006, 59:4-12.