Computerized Dynamic Posturography and Diabetic Peripheral Neuropathy

ABSTRACT

BACKGROUNDS Peripheral neuropathy secondary to diabetes mellitus is believed to cause postural insta- bility which is associated with an increased risk of falling. Posturography enables early detection of postural control failure. This study is to evaluate the relationship between postural sway assessed by a computerized dynamic posturography and peripheral neuropathy in diabetic patients who have not develo- ped clinical symptom of unsteadiness. METHODS: Computerized dynamic posturography and electrophysiological tests were performed in the following age-matched subjects: 40 type 2 diabetic patients without peripheral neuropathy, 30 type 2 dia- betic patients with peripheral neuropathy, and 30 healthy control subjects. Patients had no symptoms or clinical evidence of postural instability. RESULTS: Sensory organization test showed significant dysfunction of somatosensory function of type 2 diabetic patients with peripheral neuropathy. Posturographic parameters were all significantly impaired in the patients with peripheral neuropathy. There were no significant differences in posturographic parameters between diabetic patients without neuropathy and the healthy control subjects. Posturographic parameters showed a direct relationship with some parameters of peripheral nerve conduction. CONCLUSION: Computerized dynamic posturography showed that Type 2 diabetic patients with peripheral neuropathy have greater postural instability than those without neuropathy. A strong correlation of insta- bility with peripheral neuropathy is present in diabetic patients. This result implies that peripheral neuro- pathy plays an essential role in the instability in type 2 diabetic patients. Posturographic study allows a disclosure of the failure of postural control even in the absence of clinical evidence of postural instability.