IMPACT OF DIABETIC NEUROPATHY ON QUALITY OF LIFE AND POSTURAL BALANCE IN BRAZILIAN OLDER ADULTS.

OBJECTIVE: To analyze the impact of the Peripheral Diabetic Neuropathy (PDN) on the postural and functional balance and quality of life of Brazilian older adults. METHODS: A cross-sectional study. Sixty older men and women (60-79 years) were divided into three groups: control, DM without and with PDN. The following parameters were evaluated: anthropometry; quality of life; postural balance (BESTest); functional balance in force plate (NeuroCom Balance). RESULTS: PDN group presented significant differences compared with the other groups, with the worst performance in quality of life than DM2 without PDN in: sensory functioning (p = 0.030); past and future (p = 0.036); death and dying (p = 0.035). Postural balance deficit in the total score (p = 0.025) and biomedical constraints section (p = 0.043) of the BESTest, compared with DM2 without PDN (p = 0.007). In the functional balance (Neurocom), PDN group presented a worse performance in the time spent on the left side (p = 0.030) than the control group. During step up over test, the control group performed the task faster than the group with PDN (p = 0.004). CONCLUSION: This study showed that neuropaths presented worse physical performance and postural balance deficits, sensorial limitations, affecting the daily tasks and, as a consequence, decreasing the quality of life in Brazilian older adults. Level of Evidence II, Cross-sectional observational study.

OBJETIVO: Analisar a influência da neuropatia diabética periférica (NDP) no equilíbrio postural, atividades funcionais e na qualidade de vida em idosos. MÉTODOS: Estudo transversal. Avaliamos 60 homens e mulheres idosos (60-79 anos) divididos em três grupos: controle, DM sem e com NDP. Foram avaliados: antropometria; qualidade de vida; equilíbrio postural (BESTest); atividades funcionais pelo equilíbrio funcional na placa de força (NeuroCom Balance). RESULTADOS: Grupo NDP apresentou diferenças comparado a outros grupos, pior desempenho na qualidade de vida que o DM2 sem NDP em: funcionamento sensorial (p = 0,030); passado e futuro (p = 0,036); morte e morrer (p = 0,035). Déficit de equilíbrio postural no escore total (p = 0,025) e seção de restrições biomédicas (p = 0,043) do BESTest comparado ao DM2 sem NDP (p = 0,007). No equilíbrio funcional (Neurocom), o grupo NDP apresentou pior desempenho no tempo gasto no lado esquerdo (p = 0,030) comparado ao grupo controle. Durante a etapa de teste, o grupo controle executou a tarefa mais rapidamente que o grupo NDP (p = 0,004). CONCLUSÃO: Neuropatas apresentaram pior desempenho físico e déficits no equilíbrio postural, limitações sensoriais, afetando as tarefas diárias da doença e, consequentemente, diminuição da qualidade de vida em idosos brasileiros. Nível de Evidência II, Estudo observacional transversal.

Impact of diabetic neuropathy on quality of life and postural balance in brazilian older adults / O impacto da neuropatia diabética na qualidade de vida e equilíbrio postural em idosos brasileiros

ABSTRACT Objective: To analyze the impact of the Peripheral Diabetic Neuropathy (PDN) on the postural and functional balance and quality of life of Brazilian older adults. Methods: A cross-sectional study. Sixty older men and women (60-79 years) were divided into three groups: control, DM without and with PDN. The following parameters were evaluated: anthropometry; quality of life; postural balance (BESTest); functional balance in force plate (NeuroCom Balance). Results: PDN group presented significant differences compared with the other groups, with the worst performance in quality of life than DM2 without PDN in: sensory functioning (p = 0.030); past and future (p = 0.036); death and dying (p = 0.035). Postural balance deficit in the total score (p = 0.025) and biomedical constraints section (p = 0.043) of the BESTest, compared with DM2 without PDN (p = 0.007). In the functional balance (Neurocom), PDN group presented a worse performance in the time spent on the left side (p = 0.030) than the control group. During step up over test, the control group performed the task faster than the group with PDN (p = 0.004). Conclusion: This study showed that neuropaths presented worse physical performance and postural balance deficits, sensorial limitations, affecting the daily tasks and, as a consequence, decreasing the quality of life in Brazilian older adults. Level of Evidence II, Cross-sectional observational study.

RESUMO Objetivo: Analisar a influência da neuropatia diabética periférica (NDP) no equilíbrio postural, atividades funcionais e na qualidade de vida em idosos. Métodos: Estudo transversal. Avaliamos 60 homens e mulheres idosos (60-79 anos) divididos em três grupos: controle, DM sem e com NDP. Foram avaliados: antropometria; qualidade de vida; equilíbrio postural (BESTest); atividades funcionais pelo equilíbrio funcional na placa de força (NeuroCom Balance). Resultados: Grupo NDP apresentou diferenças comparado a outros grupos, pior desempenho na qualidade de vida que o DM2 sem NDP em: funcionamento sensorial (p = 0,030); passado e futuro (p = 0,036); morte e morrer (p = 0,035). Déficit de equilíbrio postural no escore total (p = 0,025) e seção de restrições biomédicas (p = 0,043) do BESTest comparado ao DM2 sem NDP (p = 0,007). No equilíbrio funcional (Neurocom), o grupo NDP apresentou pior desempenho no tempo gasto no lado esquerdo (p = 0,030) comparado ao grupo controle. Durante a etapa de teste, o grupo controle executou a tarefa mais rapidamente que o grupo NDP (p = 0,004). Conclusão: Neuropatas apresentaram pior desempenho físico e déficits no equilíbrio postural, limitações sensoriais, afetando as tarefas diárias da doença e, consequentemente, diminuição da qualidade de vida em idosos brasileiros. Nível de Evidência II, Estudo observacional transversal.

Positive changes in femoral nerve morphometry in older rats following aerobic training.

The objective of the present study was to analyze alterations of the femoral nerve of aged rats subjected to aerobic training. Wistar rats (12-mo of age) were divided in to two groups: S group (sedentary) and T group (trained). The exercise protocol were 16 weeks long. The groups were sacrificed at 16 months. Ultrafine sections of the femoral nerve have been used. There was no change in the body weight between the groups. T group showed a significant increase in myelinated fiber area, axon diameter, myelin sheath thickness and myelin fiber number compared with sedentary controls. In exercised trained animals, histograms of the frequency distribution of myelinated axons according to their areas showed increased number of medium and large fibers in relation to small fibers, which decreased in number. Aerobic training animals, showed the distribution of myelinated fiber population according to their area being bimodal, with the distribution shifted to the right, indicating increased fiber area. The T group showed a percent damage of large myelinated fibers significantly lower compared to controls. No significant difference was observed between the groups for the g-ratio. The T group also showed a significant increase in the number of microtubules and neurofilaments in myelinated fibers, which was not observed in S group. In conclusion, aerobic training improves nerve structure without evidence of nerve damage and produces an attenuation on the modifications in femoral nerve that develop in old age.