RESEARCH ARTICLE
The Influence of Diabetic Peripheral Neuropathy on Local Postural Muscle and Central Sensory Feedback Balance Control Nima Toosizadeh1,2☯, Jane Mohler1,2☯, David G. Armstrong1☯, Talal K. Talal3☯, Bijan Najafi1,2☯* 1 interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona, United States of America, 2 Arizona Center on Aging, University of Arizona, Tucson, Arizona, United States of America, 3 Wound and Diabetic Foot Center, Department of Medicine, Hamad Medical Co., Doha, Qatar ☯ These authors contributed equally to this work. * [email protected]
OPEN ACCESS Citation: Toosizadeh N, Mohler J, Armstrong DG, Talal TK, Najafi B (2015) The Influence of Diabetic Peripheral Neuropathy on Local Postural Muscle and Central Sensory Feedback Balance Control. PLoS ONE 10(8): e0135255. doi:10.1371/journal. pone.0135255 Editor: Aristidis Veves, Harvard Medical School, UNITED STATES Received: April 2, 2015 Accepted: July 20, 2015 Published: August 10, 2015 Copyright: © 2015 Toosizadeh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information file. Funding: The study was supported in part by Qatar National research Foundation (NPRP-4-1025-3-276) and part by an STTR-Phase II Grant (Award Number 2R42AG032748) from the National Institute on Aging. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Abstract Poor balance control and increased fall risk have been reported in people with diabetic peripheral neuropathy (DPN). Traditional body sway measures are unable to describe underlying postural control mechanism. In the current study, we used stabilogram diffusion analysis to examine the mechanism under which balance is altered in DPN patients under local-control (postural muscle control) and central-control (postural control using sensory cueing). DPN patients and healthy age-matched adults over 55 years performed two 15second Romberg balance trials. Center of gravity sway was measured using a motion tracker system based on wearable inertial sensors, and used to derive body sway and local/ central control balance parameters. Eighteen DPN patients (age = 65.4±7.6 years; BMI = 29.3±5.3 kg/m2) and 18 age-matched healthy controls (age = 69.8±2.9; BMI = 27.0±4.1 kg/ m2) with no major mobility disorder were recruited. The rate of sway within local-control was significantly higher in the DPN group by 49% (healthy local-controlslope = 1.23±1.06×10-2 cm2/sec, P
The Influence of Diabetic Peripheral Neuropathy on Local Postural Muscle and Central Sensory Feedback Balance Control Nima Toosizadeh1,2☯, Jane Mohler1,2☯, David G. Armstrong1☯, Talal K. Talal3☯, Bijan Najafi1,2☯* 1 interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona, United States of America, 2 Arizona Center on Aging, University of Arizona, Tucson, Arizona, United States of America, 3 Wound and Diabetic Foot Center, Department of Medicine, Hamad Medical Co., Doha, Qatar ☯ These authors contributed equally to this work. * [email protected]
OPEN ACCESS Citation: Toosizadeh N, Mohler J, Armstrong DG, Talal TK, Najafi B (2015) The Influence of Diabetic Peripheral Neuropathy on Local Postural Muscle and Central Sensory Feedback Balance Control. PLoS ONE 10(8): e0135255. doi:10.1371/journal. pone.0135255 Editor: Aristidis Veves, Harvard Medical School, UNITED STATES Received: April 2, 2015 Accepted: July 20, 2015 Published: August 10, 2015 Copyright: © 2015 Toosizadeh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information file. Funding: The study was supported in part by Qatar National research Foundation (NPRP-4-1025-3-276) and part by an STTR-Phase II Grant (Award Number 2R42AG032748) from the National Institute on Aging. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Abstract Poor balance control and increased fall risk have been reported in people with diabetic peripheral neuropathy (DPN). Traditional body sway measures are unable to describe underlying postural control mechanism. In the current study, we used stabilogram diffusion analysis to examine the mechanism under which balance is altered in DPN patients under local-control (postural muscle control) and central-control (postural control using sensory cueing). DPN patients and healthy age-matched adults over 55 years performed two 15second Romberg balance trials. Center of gravity sway was measured using a motion tracker system based on wearable inertial sensors, and used to derive body sway and local/ central control balance parameters. Eighteen DPN patients (age = 65.4±7.6 years; BMI = 29.3±5.3 kg/m2) and 18 age-matched healthy controls (age = 69.8±2.9; BMI = 27.0±4.1 kg/ m2) with no major mobility disorder were recruited. The rate of sway within local-control was significantly higher in the DPN group by 49% (healthy local-controlslope = 1.23±1.06×10-2 cm2/sec, P
