Wang Ting-Yun, Chen Shih-Ching, Peng Chih-Wei, Kang Chun-Wei, Chen Yu-Luen, Chen Chun-Lung, Chou Yi-Lin, Lai Chien-Hung
a Department of Physical Medicine and Rehabilitation , Taipei Medical University Hospital , Taipei , Taiwan.
b Industry-Academia Collaboration and Incubation Operation Center, Taipei Medical University , Taipei , Taiwan.
Disabil Rehabil. 2017 Mar;39(5):419-427. doi: 10.3109/09638288.2016.1146352. Epub 2016 Mar 3.
Purpose This study investigated the relationship between peripheral nerve conduction velocity (NCV) and balance performance in older adults with diabetes. Methods Twenty older adults with diabetes were recruited to evaluate the NCV of their lower limbs and balance performance. The balance assessments comprised the timed up and go (TUG) test, Berg balance scale (BBS), unipedal stance test (UST), multidirectional reach test (MDRT), maximum step length (MSL) test and quiet standing with eyes open and closed. The relationship between NCV and balance performance was evaluated by Pearson's correlation coefficients, and the balance performances of the diabetic patients with and without peripheral neuropathy were compared by using Mann-Whitney U tests. Results The NCV in the lower limbs exhibited a moderate to strong correlation with most of the balance tests including the TUG (r = -0.435 to -0.520, p < 0.05), BBS (r = 0.406-0.554, p < 0.05), UST (r = 0.409-0.647, p < 0.05) and MSL (r = 0.399-0.585, P < 0.05). In addition, patients with diabetic peripheral neuropathy had a poorer TUG (p < 0.05), BBS (p < 0.01), UST (p < 0.05) and MSL performance (p < 0.05) compared with those without peripheral neuropathy (p < 0.05). Conclusion Our findings revealed that a decline in peripheral nerve conduction in the lower limb is not only an indication of nerve dysfunction, but may also be related to the impairment of balance performance in patients with diabetes. Implications for Rehabilitation Nerve conduction velocity in the lower limbs of diabetic older adults showed moderate to strong correlations with most of the results of balance tests, which are commonly used in clinics. Decline in nerve conduction velocity of the lower limbs may be related to the impairment of balance control in patients with diabetes. Diabetic older adults with peripheral neuropathy exhibited greater postural instability than those without peripheral neuropathy.
目的 本研究调查了老年糖尿病患者外周神经传导速度(NCV)与平衡能力之间的关系。方法 招募了20名老年糖尿病患者,评估其下肢的神经传导速度和平衡能力。平衡评估包括计时起立行走(TUG)测试、伯格平衡量表(BBS)、单腿站立测试(UST)、多方向伸展测试(MDRT)、最大步长(MSL)测试以及睁眼和闭眼静立测试。通过Pearson相关系数评估神经传导速度与平衡能力之间的关系,并使用Mann-Whitney U检验比较有和没有周围神经病变的糖尿病患者的平衡能力。结果 下肢神经传导速度与大多数平衡测试呈中度至强相关,包括TUG(r = -0.435至-0.520,p < 0.05)、BBS(r = 0.406 - 0.554,p < 0.05)、UST(r = 0.409 - 0.647,p < 0.05)和MSL(r = 0.399 - 0.585,P < 0.05)。此外,与没有周围神经病变的患者相比,患有糖尿病周围神经病变的患者在TUG(p < 0.05)、BBS(p < 0.01)、UST(p < 0.05)和MSL表现(p < 0.05)方面更差(p < 0.05)。结论 我们的研究结果表明,下肢周围神经传导的下降不仅是神经功能障碍的一个指标,而且可能还与糖尿病患者平衡能力的损害有关。康复意义 老年糖尿病患者下肢的神经传导速度与临床常用的大多数平衡测试结果呈中度至强相关。下肢神经传导速度的下降可能与糖尿病患者平衡控制的损害有关。患有周围神经病变的老年糖尿病患者比没有周围神经病变的患者表现出更大的姿势不稳定性。