Evaluation of postural control in adults with type 2 diabetes mellitus

Research Objectives: To investigate the correlation between the postural control and results of clinical assessment in adults with type 2 diabetes mellitus (T2DM) using the sensory organization test (SOT).

Design: a cross-sectional and observational study

Setting: hospital and research institute setting

Participants: 8 patients diagnosed with T2DM (age:58.75±15.77, 3 males & 5 females) were recruited from the University of Kansas health system. Key inclusion criteria for T2DM patients included: (1) the age ranges from 19 to 79; (2) can walk independently (3) have at least 20/40 of visual acuity; (4) have no musculoskeletal problem that affects the balance.

Interventions: SOT was performed using a novel method-Virtual Reality Comprehensive Balance and Training (VR-ComBAT) system. Participants were instructed to stand with HTC Hive VR head-mounted display (HMD) (New Taipei City, Taiwan) and Solo Step harness system (Sioux city, SD). A VR application simulating the SOT environment with a foam pad used for conditions with uneven surfaces. AMTI force plate (Watertown, MA) was used to measure the postural sway through the center of pressure (COP). Clinical assessments including Perceived Competence Scale (PCS) for diabetes, Activity-specific Balance Confidence (ABC) scale, Falls Efficacy Scale-International (FES-I), Michigan Neuropathy Screening Instrument (MNSI), mini–Balance Evaluation Systems Test (mini-BEST) and Berg Balance Scale (BBS) were provided.

Main Outcome Measures: The postural sway based on the displacement of COP in all directions was measured. We hypothesized that the results of clinical assessments are correlated with the alteration of postural control in adults with T2DM.

Results: Mini-BEST is negatively correlated with the distance of displacement of COP in all directions, velocity in all directions and sway area. PCS is positively correlated with Frequency in the ML direction.

Conclusions: Mini-BEST can be an good objective balance assessment tool as the lower score may indicate the greater postural sway that may increase the postural instability. As a subjective assessment, PCS has the potential to predict the postural sway pattern.

Author(s) Disclosures: Research reported in this publication was supported by the Kansas University Training Program in Neurological and Rehabilitation Sciences (NIH T32HD057850).