Katoulis E C, Ebdon-Parry M, Hollis S, Harrison A J, Vileikyte L, Kulkarni J, Boulton A J
University Department of Medicine, Manchester Royal Infirmary, UK.
Diabet Med. 1997 Apr;14(4):296-300. doi: 10.1002/(SICI)1096-9136(199704)14:4<296::AID-DIA344>3.0.CO;2-5.
Diabetic peripheral neuropathy is believed to cause postural instability due to abnormal proprioception. We assessed body sway in four groups, each of 20 subjects, matched for age, sex, and BMI: non-diabetic controls, non-neuropathic diabetic controls, subjects with diabetic neuropathy and no history of foot ulceration, and subjects with diabetic neuropathy and a history of foot ulceration. Postural sway was assessed on a Kistler force plate using the Romberg test, measuring the standard deviation of the centre of pressure in both sagittal (antero-posterior movement) and frontal (side to side movement) planes with eyes open and closed. The Romberg test results were log transformed and then analysed using analysis of variance followed by Newman-Keuls test. There was no significant difference in body sway between the two control groups and the first group of subjects with diabetic neuropathy. However, in patients with a history of ulceration, values were significantly higher (p < 0.05) compared to all other groups in both planes and conditions studied. These results are suggestive of a relationship between impaired body sway control and foot ulceration. Postural instability may have clinical significance and increase the risk of minor trauma and ulceration in patients with diabetic neuropathy.
糖尿病性周围神经病变被认为会因本体感觉异常而导致姿势不稳。我们评估了四组受试者的身体摇摆情况，每组20人，在年龄、性别和体重指数方面进行了匹配：非糖尿病对照组、非神经病变性糖尿病对照组、患有糖尿病性神经病变且无足部溃疡病史的受试者，以及患有糖尿病性神经病变且有足部溃疡病史的受试者。使用罗姆伯格试验在奇石乐测力板上评估姿势摇摆，测量睁眼和闭眼时矢状面（前后移动）和额状面（左右移动）压力中心的标准差。对罗姆伯格试验结果进行对数转换，然后使用方差分析和纽曼-基尔斯检验进行分析。两个对照组与第一组患有糖尿病性神经病变的受试者之间的身体摇摆没有显著差异。然而，在有溃疡病史的患者中，在研究的两个平面和两种情况下，其数值均显著高于所有其他组（p<0.05）。这些结果表明身体摇摆控制受损与足部溃疡之间存在关联。姿势不稳可能具有临床意义，并增加糖尿病性神经病变患者发生轻微创伤和溃疡的风险。
