ABSTRACT
Background and Objectives: Diabetes mellitus (DM) has become the leading chronic disorders in nearly all countries due to urbanization, changing lifestyles and lack of physical activity. Neuropathy is the commonest and most debilitating complications of diabetes. Diabetic Peripheral Neuropathy (DPN) increases balance impairment, increasing fall risk. Consequences include decline in mobility, avoidance of activity, institutionalization and mortality; thus affecting one’s Quality of Life (Quality of Life). Previous studies have focused on balance impairment and fall risk in DPN patients and also on QoL separately. Thus, the aim of this study is to find the effect of balance impairment and fall risk on QoL. Methods: A correlational study was done on 30 DPN patients, selected by purposive sampling technique. Subjects were screened for neuropathy using Toronto Clinical Neuropathy Scoring System (TCSS) and those fulfilling the inclusion criteria, underwent balance and fall risk assessment by Berg Balance Scale (BBS) and Timed Up and Go (TUG) Test respectively. Following which, neuropathy specific quality of life questionnaire (NeuroQoL) was administered to evaluate their QoL. Results obtained were statistically analysed using SPSS 16.0, MS Word and MS Excel. Pearson’s correlation was used to find the correlation between variables. Results: The results showed statistically significant correlation between all the variables. Correlation between BBS and reduction in QoL (r=-0.540, p=0.002), TUG and reduction in QoL (r=0.531, p=0.003). Conclusion: In conclusion, physical limitations such as balance impairment and greater fall risk significantly reduces DPN patient’s QoL.
ABSTRACT
Background: The walking gait of older adults with balance impairment is affected by dual tasking. Several studies have shown that external cues can stimulate improvement in older adults’ performance. There is, however, no current evidence to support the usefulness of external cues, such as audio-visual cueing, in dual task walking in older adults. Thus, the aim of this study was to investigate the influence of an audio-visual cue (simulated traffic light) on dual task walking in healthy older adults and in older adults with balance impairments. Methods: A two-way repeated measures study was conducted on 14 healthy older adults and 14 older adults with balance impairment, who were recruited from the community in Chiang Rai, Thailand. Their walking performance was assessed using a four-metre walking test at their preferred gait speed and while walking under two further gait conditions, in randomised order: dual task walking and dual task walking with a simulated traffic light. Each participant was tested individually, with the testing taking between 15 and 20 minutes to perform, including two-minute rest periods between walking conditions. Two Kinect cameras recorded the spatio-temporal parameters using MFU gait analysis software. Each participant was tested for each condition twice. The mean parameters for each condition were analysed using a two-way repeated measures analysis of variance (ANOVA) with participant group and gait condition as factors. Result: There was no significant between-group effect for walking speed, stride length and cadence. There were also no significant effects between gait condition and stride length or cadence. However, the effect between gait condition and walking speed was found to be significant [F(1.557, 40.485) = 4.568, P = 0.024, η = 0.149]. Conclusion: An audio-visual cue (simulated traffic light) was found to influence walking speed in both healthy older adults and in older adults with balance impairment. The results suggest that audio-visual cues could be incorporated into healthy lifestyle promotion in older adults with balance impairment.