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      Equilíbrio estático em pacientes com diabetes melito tipo 2 com ou sem polineuropatia diabética Translated title: Static balance in patients presenting diabetes mellitus type 2 with and without diabetic polyneuropathy

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          Abstract

          OBJETIVOS: Comparar o equilíbrio estático em pacientes com diabetes melito tipo 2 (DM2) com ou sem polineuropatia diabética (PND) e correlacionar os escores da escala de Exame da Neuropatia Diabética (EDN) com a média da relação do centro de pressão (CoP). SUJEITOS E MÉTODOS: Vinte pacientes, com idades entre 40 e 54 anos, que apresentavam DM2 e classificados, de acordo com a escala EDN, em grupos com (n = 10) e sem (n = 10) PDN foram comparados. O equilíbrio estático foi avaliado segundo a média da relação do CoP em um Wii Balance Board® na condição com os olhos abertos e os olhos fechados. Depois da verificação da normalidade (Shapiro-Wilk), o equilíbrio entre os dois grupos foi comparado por meio dos testes t de Student e U de Mann-Whitney, como aplicável. O escore na EDN foi correlacionado com a média da relação do CoP no grupo com PND, considerando um nível de significância de p < 0,05. RESULTADOS: Diferenças significativas (p = 0,049) foram observadas nas condições de olhos fechados, com uma maior média da relação do CoP no grupo com PND (0,548 cm vs. 0,442 cm). O grupo com PND mostrou uma tendência (p = 0,059) para maior média da relação do CoP na condição com os olhos abertos (0,351 cm vs. 0,239 cm). Foi observada uma forte correlação (r = 0,751) entre o escore EDN e a média da relação do CoP na condição com os olhos fechados (p = 0,012). CONCLUSÕES: Os pacientes com PND demonstraram pior equilíbrio estático do que os pacientes sem PND na condição com os olhos fechados. Além disso, quanto maior o escore no EDN, mais forte o deslocamento do CoP, o que pode estar associado com maior risco de quedas.

          Translated abstract

          OBJECTIVES: To contrast the static balance in patients presenting diabetes mellitus type 2 (DM2) with and without polyneuropathy (DPN); and to correlate the rates from the scale Diabetic Neuropathy Examination (DNE) with the mean ratio of the center of pressure (CoP). SUBJECTS AND METHODS: Twenty patients, aged between 40 and 54, presenting DM2 and classified, according to DNE scale, in groups with (n = 10) and without (n = 10) DPN, were compared. Static balance was evaluated by means of the CoP mean ratio on a Wii Balance Board® under the conditions of open and closed eyes. After normality verification (Shapiro-Wilk), balance between both groups was compared by means of the Student t test and Mann-Whitney U test, as applicable. DNE rating was correlated with the mean ratio of CoP in the group with DPN, considering a significance level p < 0.05. RESULTS: Significant differences (p = 0.049) were found under the condition of closed eyes, with greater CoP ratio in the group with DPN (0.548 cm vs. 0.442 cm). The group with DPN showed a tendency (p = 0.059) towards a greater CoP mean ratio under the open eyes condition (0.351 cm vs. 0.239 cm). There was a strong correlation (r = 0.751) between the DNE rating and the CoP mean ratio under the closed eyes condition (p = 0.012). CONCLUSIONS: Patients showing DPN demonstrated worse static balance than patients without DPN in the closed eyes condition. Furthermore, the higher the rating in DNE, the stronger the displacement of CoP, which may be associated with higher risk of falls.

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          Most cited references27

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          Revision of posturography based on force plate for balance evaluation.

          The maintenance of balance and body orientation in humans is guaranteed by the adequate functioning of the postural control system. The investigation of this control has awakened the interest of professionals from several fields such as Physical Therapy, Physical Education, Engineering, Physics, Medicine, Psychology, and others. The purposes of this study are to revise the methods of data analysis used to investigate the postural control in human beings and to demonstrate the computational algorithms of the main measures used in the postural control evaluation. The experimental procedures and measures used in postural control evaluation presented in this review can help in the standardization of postural control investigation.
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            Diabetes Treatment, Part 3: Insulin and Incretins

            M J Fowler (2008)
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              Investigation of standing balance in patients with diabetic neuropathy at different stages of foot complications.

              Diabetic peripheral neuropathy is known to cause postural instability. This study investigated standing balance in patients with diabetic neuropathy with secondary foot complications: foot ulceration, partial foot amputation and trans-tibial amputation, which are expected to pose further challenge to balance control.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                abem
                Arquivos Brasileiros de Endocrinologia & Metabologia
                Arq Bras Endocrinol Metab
                Sociedade Brasileira de Endocrinologia e Metabologia (São Paulo )
                1677-9487
                December 2013
                : 57
                : 9
                : 722-726
                Affiliations
                [1 ] Universidad Austral de Chile Chile
                Article
                S0004-27302013000900008
                10.1590/S0004-27302013000900008
                a3f0eb1e-01d5-479f-9851-bed2564965b5

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-2730&lng=en
                Categories
                ENDOCRINOLOGY & METABOLISM

                Endocrinology & Diabetes
                Postural balance,diabetic polyneuropathy,diabetes mellitus, type 2,diabetic complications,Equilíbrio postural,polineuropatia diabética,diabetes melito tipo 2,complicações do diabetes

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