Postural Instability and Fall Risk in Type 2 Diabetes: A Cross-Sectional Study Using Posturography and Video Head Impulse Test.
To investigate vestibular function, postural stability, and fall risk in individuals with type 2 diabetes mellitus (T2DM) with and without diabetic polyneuropathy (DPN), compared with healthy controls.
A cross-sectional study.
University hospital outpatient clinic.
A total of 128 adults participated: 51 with T2DM and DPN, 38 with T2DM without DPN, and 39 healthy controls. Participants were consecutively recruited and classified based on clinical and electrophysiologic evaluation of DPN.
Not applicable.
Vestibular function was assessed using the video head impulse test (vHIT). Postural stability was measured by computerised posturography (F2-F4 sway, Stability Index, Fall Risk Index). Fall concern was assessed by questionnaire, and fall history within the past year was self-reported.
Abnormal vHIT findings were rare (7%) and there were no group differences. Participants with T2DM and DPN demonstrated significantly higher F2-F4 sway compared with both T2DM without DPN and controls. A similar pattern was observed for the Stability Index, while the Fall Risk Index did not differ between groups. Participants with a heightened fall concern and paticipants reporting falls within the past year had greater F2-F4 sway . Logistic regression analysis confirmed an independent association between F2-F4 sway and fall history.
Computerised posturography, particularly F2-F4 sway, identified balance impairment and increased fall risk in individuals with T2DM, especially those with DPN. Abnormal vHIT findings were rare and unrelated to falls, suggesting a limited role of vHIT-detectable vestibular dysfunction in this population.
A cross-sectional study.
University hospital outpatient clinic.
A total of 128 adults participated: 51 with T2DM and DPN, 38 with T2DM without DPN, and 39 healthy controls. Participants were consecutively recruited and classified based on clinical and electrophysiologic evaluation of DPN.
Not applicable.
Vestibular function was assessed using the video head impulse test (vHIT). Postural stability was measured by computerised posturography (F2-F4 sway, Stability Index, Fall Risk Index). Fall concern was assessed by questionnaire, and fall history within the past year was self-reported.
Abnormal vHIT findings were rare (7%) and there were no group differences. Participants with T2DM and DPN demonstrated significantly higher F2-F4 sway compared with both T2DM without DPN and controls. A similar pattern was observed for the Stability Index, while the Fall Risk Index did not differ between groups. Participants with a heightened fall concern and paticipants reporting falls within the past year had greater F2-F4 sway . Logistic regression analysis confirmed an independent association between F2-F4 sway and fall history.
Computerised posturography, particularly F2-F4 sway, identified balance impairment and increased fall risk in individuals with T2DM, especially those with DPN. Abnormal vHIT findings were rare and unrelated to falls, suggesting a limited role of vHIT-detectable vestibular dysfunction in this population.
Authors
Lund Lund, Bendtsen Bendtsen, Andersen Andersen, Tankisi Tankisi, Khan Khan, Devantier Devantier
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