18.1 Analysis of postural stability in diabetes/peripheral neuropathy during threshold level acceleration perturbation

Background - The most common complication in patients with type 2 diabetes is peripheral neuropathy. Physical exercise is one of the effective Prevention and treatment strategies of peripheral neuropathy in type 2 diabetes. Aims and objectives - The aim of this review articles is to describe the effectiveness of physical exercise on peripheral neuropathy sensation in patients with type 2 diabetes. Methods - A number of databases such as Science Direct, Springer Link, ProQuest, EBSCOhost, and Google Scholar were searched for relevant articles using keywords such as “type 2 diabetes”, AND “peripheral neuropathy sensation” OR “diabetes peripheral neuropathy" AND “physical exercises” OR “aerobic exercises” OR “resistance exercise”. All types of articles were included for the study, such as systematic reviews, randomized controlled trial, quasi-experiment, literature review, and pilot study with the range 2015-2020. Only articles in English are included in this review. Results - Of the 11 articles found, 9 articles showed that physical exercise had a direct effect on improving foot sensation in diabetic peripheral neuropathy patients, while the other 2 articles had an indirect effect on improving symptoms of peripheral neuropathy. Four types of physical exercise that are practiced in interventions are: aerobic exercise, resistance exercise, balance and flexibility exercise and a combination of two or more types of exercise. Physical exercise from low to moderate intensity has a positive effect on increasing foot sensation in patients with type 2 diabetes peripheral neuropathy. Conclusions – This review emphasizes the effect of physical exercise on peripheral neuropathic sensation in type 2 DM patients and strengthens the evidence that low and moderate-intensity exercise are beneficial to reduce peripheral neuropathy symptoms. Further research on the effectiveness of home and community-based physical exercise to reduce symptoms of peripheral neuropathy is necessary.

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A New Postural Stability-Indicator to Predict the Level of Fear of Falling In Parkinson’s Disease Patients

10.21203/rs.3.rs-32976/v1 ◽

2020 ◽

Author(s):

Ehsan Pourghayoomi ◽

Saeed Behzadipour ◽

Mehdi Ramezani ◽

Mohammad Taghi Joghataei ◽

Gholamali shahidi

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Postural Stability ◽

Human Error ◽

Fear Of Falling ◽

Center Of Pressure ◽

Threshold Level ◽

Berg Balance Scale ◽

Self Report ◽

Timed Up And Go

Abstract Background Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. 70% of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error. Objectives In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRi’s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF related behavior(s). Results FTR 1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = − 0.63, P < 0.001), Pull Test (r = − 0.65, P < 0.001), Timed Up and Go test (r = − 0.57, P < 0.001), and Berg Balance Scale (r = 0.62, P < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions Using the proposed assessment technique we can accurately predict the intensity of FoF in PD patients. Also, The FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

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The Influence of Peripheral Neuropathy, Gender, and Obesity on the Postural Stability of Patients with Type 2 Diabetes Mellitus

Journal of Diabetes Research ◽

10.1155/2014/787202 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Aline Herrera-Rangel ◽

Catalina Aranda-Moreno ◽

Teresa Mantilla-Ochoa ◽

Lylia Zainos-Saucedo ◽

Kathrine Jáuregui-Renaud

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Peripheral Neuropathy ◽

Postural Stability ◽

Static Posturography ◽

Gender And Age ◽

Soft Surface ◽

History Of

Aim.To assess the influence of peripheral neuropathy, gender, and obesity on the postural stability of patients with type 2 diabetes mellitus.Methods.151 patients with no history of otology, neurology, or orthopaedic or balance disorders accepted to participate in the study. After a clinical interview and neuropathy assessment, postural stability was evaluated by static posturography (eyes open/closed on hard/soft surface) and the “Up & Go” test.Results.During static posturography, on hard surface, the length of sway was related to peripheral neuropathy, gender, age, and obesity; on soft surface, the length of sway was related to peripheral neuropathy, gender, and age, the influence of neuropathy was larger in males than in females, and closing the eyes increased further the difference between genders. The mean time to perform the “Up & Go” test was 11.6 ± 2.2 sec, with influence of peripheral neuropathy, gender, and age.Conclusion.In order to preserve the control of static upright posture during conditions with deficient sensory input, male patients with type 2 diabetes mellitus with no history of balance disorders may be more vulnerable than females, and obesity may decrease the static postural control in both males and females.

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Limited Access Trial Using Amifostine for Protection Against Cisplatin- and Three-Hour Paclitaxel–Induced Neurotoxicity: A Phase II Study of the Gynecologic Oncology Group

Journal of Clinical Oncology ◽

10.1200/jco.2003.02.086 ◽

2003 ◽

Vol 21 (22) ◽

pp. 4207-4213 ◽

Cited By ~ 56

Author(s):

David H. Moore ◽

James Donnelly ◽

William P. McGuire ◽

Lois Almadrones ◽

David F. Cella ◽

...

Keyword(s):

Peripheral Neuropathy ◽

Gynecologic Oncology ◽

Threshold Level ◽

Phase Iii ◽

Gynecologic Oncology Group ◽

Oncology Group ◽

Characteristic Analysis ◽

Perception Threshold ◽

Clinically Significant ◽

Chemotherapy Patients

Purpose: The purpose of this study was to determine whether amifostine (WR-2721) prevents or ameliorates clinically significant (grade 2 to 4) neurotoxicity associated with cisplatin and 3-hour paclitaxel chemotherapy. Materials and Methods: The chemotherapy program consisted of intravenous paclitaxel 175 mg/m2 over 3 hours followed by amifostine 740 mg/m2 and cisplatin 75 mg/m2 administered over 90 minutes beginning 15 minutes after amifostine administration. At baseline, before each treatment cycle, and for 3 months after completing chemotherapy, patients were evaluated for evidence of neurotoxicity and other treatment-related adverse effects using three methods: standard clinical evaluation (National Cancer Institute common toxicity criteria [CTC] grading), a neurotoxicity questionnaire to assess symptoms and limitations imposed by peripheral neuropathy, and vibration perception threshold (VPT) testing. Results: Four of 27 assessable patients developed grade 2 to 4 neurotoxicity based on clinical assessments and CTC grading. This number of neuropathic events exceeded the predetermined threshold level for a second stage of accrual and the study was closed. Conclusion: Amifostine’s level of activity in this trial was insufficient to warrant further study in a phase III trial. Based on the receiver operating characteristic analysis, it would appear that VPT measurements are less sensitive to the development of peripheral neuropathy than the neurotoxicity questionnaire. The questionnaire, referred to as the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity, may be used instead of VPT measurements in future studies of chemotherapy-induced peripheral neuropathy.

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