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Postural stability in patients with Parkinson’s disease versus patients with type 2 diabetes mellitus

Abstract

Background

Postural control is defined as the control of body’s position in space for balance purpose. Postural control in static conditions is known as postural steadiness, whereas in the dynamic volitional perturbations, it is noted as postural stability. Postural stability can be affected owing to central or peripheral lesions; one of the central lesions with postural instability is Parkinson’s disease (PD). However, peripheral neuropathies that affect stability are one of the most common complications of diabetes mellitus.

Aim

The aim was to assess postural stability in patients with PD and those with type 2 diabetes as examples of central and peripheral lesions, respectively, and to compare the results with the findings obtained from the normal control group.

Patients and Methods

The patient group in the study was divided into two subgroups: subgroup 1 consisted of 15 patients diagnosed as having PD and subgroup 2 included 15 patients with type 2 diabetes mellitus. Control group consisted of 15 normal age-matched participants. Postural assessment was performed using computerized dynamic posturography. This included the automatic motor assessments tests, including motor control test and adaptation test, and functional limitation tests such as tandem walk.

Results

This research showed that there is a statistically significant difference between control group and subgroup with PD in all tested parameters. A statistically significant difference was found between control group and subgroup with diabetes in all parameters of adaptation test and speed test. Moreover, there is a statistically significant difference between the two subgroups in most of tested parameters, with the highest value in PD group.

Conclusion

The findings reflect that postural stability is more affected with central lesion than peripheral lesion.

References

  1. Jáuregui-Renaud K. Postural balance and peripheral neuropathy. Instituto Mexicano del Seguro Social, México: INTECH; 2013.

    Book  Google Scholar 

  2. Chaudhry H, Findley T, Quigley KS, Bukiet B, Ji Z, Sims T, Maney M. Measures of postural stability. J Rehabil Res Dev 2004; 41:713–720.

    Article  Google Scholar 

  3. Timar B, Timar R, Gaiă L, Oancea C, Levai C, Lungeanu D. The impact of diabetic neuropathy on balance and on the risk of falls in patients with type 2 diabetes mellitus: a cross-sectional study. PLoS One 2016; 11:e0154654.

    Article  Google Scholar 

  4. Uhrbrand A, Stenager E, Pedersen MS, Dalgas U. Parkinson’s disease and intensive exercise therapy – a systematic review and meta-analysis of randomized controlled trials. J Neurol Sci 2015; 353:9–19.

    Article  Google Scholar 

  5. Lenka A, Jhunjhunwala KR, Saini J, Pal PK. Structural and functional neuroimaging in patients with Parkinson’s disease and visual hallucinations: a critical review. Parkinsonism Relat Disord 2015; 21: 683–691.

    Article  Google Scholar 

  6. Vaugoyeau M, Azulay J. Role of sensory information in the control of postural orientation in Parkinson’s disease. J Neurol Sci 2010; 289:66–68.

    Article  Google Scholar 

  7. Tolosa E, Gaig C, Santamaría J, Compta Y. Diagnosis and the premotor phase of Parkinson disease. Neurology 2009; 72:S12–S20.

    Article  Google Scholar 

  8. Lopes JBP, du Lameira de Melo GE, Lazzari RD, Santos CA, Franco de Moura RC, et al. Measures used for the evaluation of balance in individuals with Parkinson’s disease: a systematic review. J Phys Ther Sci 2016; 28:1936–1942.

    Article  Google Scholar 

  9. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for2010 and 2030. Diabetes Res Clin Pract 2010; 87:4–14.

    Article  CAS  Google Scholar 

  10. Ilksan D, Nursen I, Barı G, Candan A. The effect of type 2 diabetes mellitus on the motor behaviour of elderly individuals during sit to stand activity. J Marmara Univ Inst Health Sci 2012; 2:72–77.

    Google Scholar 

  11. Kim R, Edelman S, Kim D. Musculoskeletal complications of diabetes mellitus. Clin Diabetes 2001; 19:132–135.

    Article  Google Scholar 

  12. Jeremiah D, Keith C, Stephen M, John W, Kristin A. Diabetic neuropathy: an intensive review. Am J Health Syst Pharm 2004; 61:2.

    Google Scholar 

  13. Djaldetti R, Ziv I, Melamed E. The mystery of motor asymmetry in Parkinson’s disease. Lancet Neurol 2006; 5:796–802.

    Article  Google Scholar 

  14. Rocchi L, Chiari L, Horak FB. Effects of deep brain stimulation and levodopa on postural sway in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2002; 73:267–274.

    Article  CAS  Google Scholar 

  15. Van der Kooij H, van Asseldonk EH, Geelen J, van Vugt JP, Bloem BR. Detecting asymmetries in balance control with system identification: first experimental results from Parkinson patients. J Neural Transm 2007; 114: 1333–1337.

    Article  Google Scholar 

  16. Fisher I. Reliability and validity of the modified functional reach test at the sub-acute stage post-stroke. Disabil Rehabil 2009; 31:243–248.

    Article  Google Scholar 

  17. Haas C, Turbanski S, Kessler K, Schmidtbleicher D. The effects of random whole-body-vibration on motor symptoms in Parkinson’s disease. Neuro Rehabilitation 2006; 21:1878–6448.

    Google Scholar 

  18. Jauregui-Renaud K. Postural balance and peripheral neuropathy Instituto Mexicano del Seguro Social. Mexico: InTechOpen; 2013.

    Google Scholar 

  19. Mokhtar M, Mostafa M, Abd El Halim N, Helmy M, Samir W. Postural control and central motor pathway involvement in type 2 diabetes mellitus: dynamic posturographic and electrophysiologic studies. Alex J Med 2013; 49: 299–307.

    Article  Google Scholar 

  20. Mustapa A, Justine M, Mohd Mustafah N, Jamil N, Manaf H. Postural control and gait performance in the diabetic peripheral neuropathy: a systematic review. Bio Med Research International 2016; 2016:9305025.

    Google Scholar 

Download references

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Correspondence to Soha M. Hamada MD.

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Hamada, S.M. Postural stability in patients with Parkinson’s disease versus patients with type 2 diabetes mellitus. Egypt J Otolaryngol 34, 84–89 (2018). https://doi.org/10.4103/ejo.ejo_43_17

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