Chun Jihyun, Hong Junggi
Department of Sports and Health Rehabilitation, Kookmin University, Republic of Korea.
J Phys Ther Sci. 2015 Sep;27(9):2697-700. doi: 10.1589/jpts.27.2697. Epub 2015 Sep 30.
[Purpose] Diabetic peripheral neuropathy can often lead to balance impairment. The spinal reflex is a mechanism that is reportedly important for balance, but it has not been investigated in diabetic peripheral neuropathy patients. Moreover, inhibitory or facilitatory behavior of the spinal reflex-known as presynaptic inhibition-is essential for controlling postural sway. The purpose of this study was to compare the differences in as presynaptic inhibition and balance in subjects with and without diabetic peripheral neuropathy to determine the influence of presynaptic inhibition on balance in diabetic peripheral neuropathy patients. [Subjects and Methods] Presynaptic inhibition and postural sway were tested in eight patients (mean age, 58±6 years) and eight normal subjects (mean age, 59±7 years). The mean percent difference in conditioned reflex amplitude relative to the unconditioned reflex amplitude was assessed to calculate as presynaptic inhibition. The single-leg balance index was measured using a computerized balance-measuring device. [Results] The diabetic peripheral neuropathy group showed lower presynaptic inhibition (47±30% vs. 75±22%) and decreased balance (0.65±0.24 vs. 0.38±0.06) as compared with the normal group. No significant correlation was found between as presynaptic inhibition and balance score (R=0.37). [Conclusion] Although the decreased as presynaptic inhibition observed in diabetic peripheral neuropathy patients may suggest central nervous system involvement, further research is necessary to explore the role of presynaptic inhibition in decreased balance in diabetic peripheral neuropathy patients.
[目的] 糖尿病周围神经病变常可导致平衡功能受损。脊髓反射是一种据报道对平衡很重要的机制，但尚未在糖尿病周围神经病变患者中进行研究。此外，脊髓反射的抑制或易化行为（即突触前抑制）对于控制姿势摆动至关重要。本研究的目的是比较有和没有糖尿病周围神经病变的受试者在突触前抑制和平衡方面的差异，以确定突触前抑制对糖尿病周围神经病变患者平衡的影响。[对象与方法] 对8例患者（平均年龄58±6岁）和8名正常受试者（平均年龄59±7岁）进行突触前抑制和姿势摆动测试。评估条件反射幅度相对于非条件反射幅度的平均百分比差异以计算突触前抑制。使用计算机化平衡测量装置测量单腿平衡指数。[结果] 与正常组相比，糖尿病周围神经病变组表现出较低的突触前抑制（47±30% 对75±22%）和平衡能力下降（0.65±0.24对0.38±0.06）。突触前抑制与平衡评分之间未发现显著相关性（R=0.37）。[结论] 虽然在糖尿病周围神经病变患者中观察到的突触前抑制降低可能提示中枢神经系统受累，但需要进一步研究以探讨突触前抑制在糖尿病周围神经病变患者平衡能力下降中的作用。
