1 Queen's University, Kingston, Ontario, Canada.
J Appl Gerontol. 2017 Aug;36(8):1032-1044. doi: 10.1177/0733464815602341. Epub 2015 Aug 30.
This study examined possible subtle degradation in sensory functions, balance, and mobility in older adults with type 2 diabetes (T2D) prior to overt development of diabetic peripheral neuropathy (DPN). Twenty-five healthy controls (HC group, age = 74.6 ± 5.4) and 35 T2D elderly without DPN (T2D group, age = 70.6 ± 4.7) were recruited. Sensory assessment included vibrotactile sensitivity, bilateral caloric weakness, and visual contrast sensitivity. Self-report measures comprised of Activity-Specific Balance Confidence (ABC), Human Activity Profile-adjusted activity scores (HAP-AAS), falls, and mobility disability. Performance measures included modified Timed-Up and Go (mTUG), Clinical Test of Sensory Integration for Balance (mCTSIB), and Frailty and Injuries (FICSIT-4) balance test. T2D group demonstrated significantly worse bilateral caloric weakness, marginally higher threshold of vibrotactile sensitivity and lower visual contrast sensitivity, and as well as signifcantly lower HAP-AAS. A significantly higher proportion of the T2D group failed mCTSIB Condition 4 than in the HC group. Subtle changes in multiple sensory systems of older adults with T2D may reduce redundancy available for balance control while performing challenging activities much before DPN development.
本研究旨在探讨 2 型糖尿病(T2D)老年患者在明显发生糖尿病周围神经病变(DPN)之前,其感觉功能、平衡和移动能力是否存在潜在的退化。研究共纳入了 25 名健康对照组(HC 组,年龄=74.6±5.4 岁)和 35 名无 DPN 的 T2D 老年患者(T2D 组,年龄=70.6±4.7 岁)。感觉评估包括振动觉敏感性、双侧热刺激减弱和视觉对比敏感度。自我报告的评估包括活动特异性平衡信心量表(ABC)、人类活动概况调整活动评分(HAP-AAS)、跌倒和移动障碍。表现评估包括改良计时起立行走测试(mTUG)、平衡临床感觉整合测试(mCTSIB)和脆弱性和损伤(FICSIT-4)平衡测试。T2D 组表现出明显更差的双侧热刺激减弱、振动觉敏感性阈值略高、视觉对比敏感度降低,以及 HAP-AAS 明显降低。T2D 组 mCTSIB 第 4 项条件的失败率明显高于 HC 组。T2D 老年患者的多种感觉系统出现细微变化,可能会降低在执行具有挑战性的活动时平衡控制的冗余度,而这发生在 DPN 发展之前。