Auxiliary Sensory Cues Improve Automatic Postural Responses in Individuals With Diabetic Neuropathy

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Abstract
Background . A loss of sensation in the lower limbs, observed in individuals with diabetes as well as elderly individuals, contributes to postural instability, altered gait patterns, increased risk of falling, and decreased quality of life. Objective . To determine if somatosensory cues delivered to sensate areas of the lower limbs above the ankle joints enhance the control of posture in individuals with peripheral neuropathy. Methods . Twelve subjects with sensory neuropathy due to diabetes participated in static and dynamic balance tests with and without auxiliary sensory cues provided to the lower limbs without stabilizing the ankle joints. During the tests the subjects were required to stand on a fixed or moving computer-controlled platform with their eyes open or closed. Equilibrium scores and response latency were obtained. Results . For all tests, equilibrium scores were significantly larger in experiments with auxiliary sensory cues in comparison with conditions without cues ( P < .05). Smaller latency scores were recorded in conditions with auxiliary sensory information. The results indicate that auxiliary sensory cues improved automatic postural responses. Conclusions . The observed enhancement of automatic postural responses has clinical implications that aid in the understanding of postural control in individuals with peripheral neuropathy. Future controlled trials could examine whether devices that provide auxiliary sensory cues can improve balance, mobility, and the performance of daily activities.

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