The researchers found no differences in any variables in patients with diabetic peripheral neuropathy, as compared with controls or diabetes patients without peripheral neuropathy, while climbing or descending stairs.
“Diabetes patients with peripheral neuropathy display greater extremes in magnitude of medial-lateral sway during stair ascent and descent as well as displaying higher variability during stair ascent and descent. This indicates that patients with [diabetic peripheral neuropathy] have difficulty regulating control of balance during this challenging task,” the researchers wrote in an abstract.
“A larger and more variable medial-lateral sway means that patients with [diabetic peripheral neuropathy] are more likely to lose control of balance and experience a fall during what is known to be an activity — using stairs — where the risk of falls is already high.”
In a press release, the researchers suggest that patients with diabetic peripheral neuropathy should take measures to protect themselves but need not avoid stairs altogether, as that would be impractical.
“Avoiding particularly steep and/or long flights of stairs may be advisable, especially if an elevator is available as an alternative. Using a handrail on stairs if available could also help patients with diabetic peripheral neuropathy prevent falls,” they said.
“Since our research has identified details regarding how patients with diabetic peripheral neuropathy sway, and therefore how they are most at risk, this may allow future research to target balance interventions to improve the medial-lateral balance in this population,” the researchers added.
To learn more about what may cause unsteadiness in this patient population, the researchers plan to investigate the gait of those with diabetic peripheral neuropathy and how this complication affects walking on level ground and on stairs.
“Many issues that affect balance in patients with diabetic peripheral neuropathy stem from deterioration of muscle size and function, so whilst it is not currently possible to positively improve the sensory deterioration, we have been looking at elements that we can positively influence, such as strength training and interventions to help vision focus and avoidance of obstacles. We are investigating the impact of such interventions and how they might translate to improvements in gait and balance control,” they said in the release.
- Brown SJ et al. Oral Presentation 129. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 15-19, 2014; Vienna, Austria.