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Climbing stairs may be more dangerous for patients with diabetic peripheral neuropathy, according to research presented at the European Association for the Study of Diabetes Annual Meeting. Specifically, the complication appears to adversely affect patients’ balance.
Studies have demonstrated an increased likelihood of swaying while standing or walking on level ground in patients with diabetic peripheral neuropathy, but researchers have yet to assess balance while climbing or descending stairs.
To investigate this further, Steven Brown, of Manchester Metropolitan University in the United Kingdom, and colleagues analyzed motion and force data from 22 patients with diabetes and peripheral neuropathy (mean age, 57 years), 40 patients with diabetes and no peripheral neuropathy (mean age, 57 years) and 32 healthy people without diabetes (mean age, 50 years).
The researchers gathered movement data via a 10-camera 3D motion analysis system from reflective markers placed at anatomical locations on the body to calculate whole-body center-of-mass (CoM), according to the study abstract.
Additionally, participants ascended and descended stairs with four force platforms mounted into the middle of four steps on a seven-step staircase at least three times so researchers could gauge center-of-pressure (CoP) under the feet.
The researchers also analyzed balance using separation between the center-of-mass and center-of-pressure (CoM-CoP separation) in the medial-lateral plane.
Study Findings
Results indicated that, while climbing stairs, patients with diabetic peripheral neuropathy had a significantly higher maximum CoM-CoP separation of 13 cm vs. 10 cm for those with diabetes only and 10 cm for healthy controls (P<.01).
The researchers also noted significantly increased variation in CoM-CoP separation, with 7 cm in the diabetic peripheral neuropathy group, 5 cm in the diabetes-only group and 6 cm in the control group (P<.05), according to the data.
Similar differences were observed while patients descended stairs, the researchers reported. Significantly higher maximum CoM-CoP separation was also found in the diabetic peripheral neuropathy group, as compared with the diabetes-only and control groups (15 cm vs. 13 cm and 12 cm; P<.05).
Once again, variation in CoM-CoP separation was significantly increased in those with diabetic peripheral neuropathy, as compared with the patients with diabetes only and controls (8 cm vs. 7 cm and 7 cm; P<.01).
Patients with diabetic peripheral neuropathy also demonstrated a wider stance width than the other two study groups, but this was only evident during stair descent (mean stance width, 17 cm vs. 15 cm and 15 cm; P<.05).
