University of Rochester, School of Nursing, 255 Crittenden Blvd, Rochester, NY, 14642, USA.
University of Rochester, Department of Orthopaedics, 601 Elmwood Ave, Rochester, NY, 14642, USA.
Gait Posture. 2021 Jan;83:141-146. doi: 10.1016/j.gaitpost.2020.10.016. Epub 2020 Oct 20.
People with diabetes mellitus and peripheral neuropathy (DMPN) often have balance and mobility deficits. Time-to-boundary (TTB) is a parameter of postural control that combines position and velocity center of pressure data. While not previously investigated, assessment of TTB may provide new insight regarding postural control in people with DMPN.
Is TTB reduced and related to a measure of mobility in people with DMPN?
Thirteen people with DMPN without fall history and 13 healthy matched controls participated in this case-control study. Participants stood in double-limb stance on a force plate. The anterior-posterior and medial-lateral center of pressure position and velocity relative to the boundaries of the base of support were used to calculate TTB (s). Lower values indicate less postural control. Time-to-failure during single-limb stance was a secondary measure of postural control. Time to complete the Timed Up and Go (TUG) was our measure of mobility. Longer TUG times correspond to decreased mobility, strength, and balance. Independent t-tests or Mann-Whitney U tests were conducted to assess group differences. Bivariate correlations between task outcomes were conducted.
Anterior-posterior TTB and single-limb stance times were shorter in people with DMPN (p ≤ 0.04). TUG times were longer in the DMPN group (p = 0.04). In the DMPN group, inverse relationships were observed between TTB and TUG (anterior-posterior R = .34; medial-lateral R = .49; both p = 0.01), but not between single-limb stance times and TTB or TUG.
TTB was a sensitive measure of postural control in people with DMPN. The detected relationship between TTB and TUG newly establishes TTB as a clinically meaningful indicator of balance and function. Study findings may serve to further guide balance screening and rehabilitation efforts in people with DMPN.
患有糖尿病和周围神经病变（DMPN）的人通常存在平衡和移动能力缺陷。到达边界时间（TTB）是一种结合了位置和速度的姿势控制参数，压力中心数据。虽然之前没有研究过，但评估 TTB 可能会提供有关 DMPN 患者姿势控制的新见解。
TTB 是否会降低，并且与 DMPN 患者的移动能力测量值相关？
13 名无跌倒史的 DMPN 患者和 13 名健康匹配的对照者参加了这项病例对照研究。参与者在测力板上站立双腿。使用前后中心压力位置和速度相对于支撑基础边界的速度来计算 TTB（s）。较小的值表示姿势控制较差。单腿站立时的失败时间是姿势控制的次要测量指标。完成计时起立行走测试（TUG）的时间是我们移动能力的测量指标。较长的 TUG 时间对应于移动能力、力量和平衡能力的下降。进行独立样本 t 检验或曼-惠特尼 U 检验以评估组间差异。进行任务结果之间的双变量相关性分析。
DMPN 患者的前后 TTB 和单腿站立时间更短（p≤0.04）。DMPN 组的 TUG 时间更长（p=0.04）。在 DMPN 组中，TTB 与 TUG 之间存在反向关系（前后 R=0.34；内侧 R=0.49；两者均 p=0.01），但单腿站立时间与 TTB 或 TUG 之间无相关性。
TTB 是 DMPN 患者姿势控制的敏感测量指标。TTB 与 TUG 之间的检测关系首次将 TTB 确立为平衡和功能的具有临床意义的指标。研究结果可能有助于进一步指导 DMPN 患者的平衡筛查和康复工作。
