Effect of sensory impairment on balance performance and lower limb muscle strength in older adults with type 2 diabetes

Abstract

© 2019 by Korean Academy of Rehabilitation Medicine. Objective To compare balance performance and lower limb muscle strength between older adults with type 2 dia- betes mellitus (DM), with and without sensory impairments and non-DM groups. Influence of a number of sen- sory impairments, and muscle strength on balance performance were explored. Methods Ninety-two older adults with and without type 2 DM, were examined relative to visual function with the Snellen chart, Melbourne Edge test, and Howard-Dolman test, vestibular function with the modified Romberg test, proprioception of the big toe, and diabetic peripheral neuropathy with the Michigan Neuropathy Screening Instrument. Balance performances were evaluated with the Romberg test, Functional Reach Test (FRT), and Timed Up and Go test (TUG). Strength of knee and ankle muscles was measured. Results FRT of type 2 DM groups with at least two sensory impairments, was lower than the non-DM group (p < 0.05). TUG of all DM groups, was worse than the non-DM group (p < 0.01). Lower limb muscle strength of type 2 DM groups with two and three sensory impairments, was weaker than non-DM group (p < 0.05). Regression analysis showed that type 2 DM with three sensory impairments, ankle dorsiflexors strength, and age were influential predictors of TUG. Conclusion There were significant differences, of muscle strength and balance performance among groups. Poorer balance and reduced lower limb strength were marked in older adults with type 2 DM, even ones without sensory impairment. Muscle weakness seemed to progress, from the distal part of lower limbs. A greater number of sensory impairments, weaker dorsiflexors, and advanced age influenced balance performance.