Effect of Sensory Impairment on Balance Performance and Lower Limb Muscle Strength in Older Adults With Type 2 Diabetes

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.

Predictors of Community Participation Among Individuals With First Stroke: A Thailand Study

OBJECTIVE: To describe perceived participation among persons with first stroke and to identify the predictors based on the International Classification of Functioning, Disability and Health (ICF) concept of participation after stroke. METHODS: A total of 121 participants completed 4 questionnaires: the Impact on Participation and Autonomy (IPA), Personal Resource Questionnaire (PRQ2000), Hospital Anxiety and Depression Scale (HADS), and personal history. They were evaluated for their balance, motor function, functional and walking ability. RESULTS: The majority of participants perceived participation restriction in family role as poor to very poor. The best predictors of participation included social support, walking and balance, functional ability, number of secondary health problems and affected side, account for 66.6% of the variances in participation. CONCLUSION: The study highlights the importance of social support, walking and balance performance, functional ability in daily living, and number of secondary health problems after stroke. These factors that facilitate participation after stroke should be addressed by health personnel during rehabilitation.

Effect of Superficial Heating Duration on Plantarflexor Extensibility.

Objectives: This study aimed to compare the immediate effect of different durations of superficial heating on the extensibility of the plantarflexors. Materials and methods: Seventy-five healthy subjects were randomized into one of 3 groups: no heating (control), 15-minute superficial heating, or 30-minute superficial heating. Ankle dorsiflexion active range of motion (AROM) in the lunge position was used as the indicator of plantarflexor’s extensibility, with the lunge position tests performed before and immediately after the intervention. Results: Immediately after the 15-minute heating intervention, the ankle dorsiflexion AROM was significantly increased in this group. The control and 30-minute heating groups did not have any increase of ankle dorsiflexion AROM. Conclusion: Superficial heating in the form of hot pack application proved to have an immediate effect in increasing plantarflexor muscle extensibility. The 15-minute application of heating improved the degree of ankle dorsiflexion. This study proposed that 15 minutes of heating was effective in increasing dorsiflexion AROM in healthy subjects.