Article

Individuals with diabetic neuropathy sway more than control
individuals while standing. This review specifically evaluated whether peripheral
sensory neuropathy can be the only fundamental reason accounting for significant
increased sway within this population. METHODS: Twenty-six experimental articles
were selected using MEDLINE and reference lists of relevant articles. The
articles chosen investigated kinematic data of postural behaviour in controls and
individuals with diabetic neuropathy during stance. Results of literature were
compared with four expectations related to the peripheral sensory neuropathy
fundamental hypothesis. FINDINGS: Consistent with the peripheral sensory
neuropathy hypothesis, the literature showed that individuals with diabetic
neuropathy sway more than controls in quiet stance and even more so if their
visual or vestibular systems were perturbed. Inconsistent with the hypothesis,
individuals with diabetic neuropathy are more destabilised than controls in
conditions altering sensation of the feet and legs (standing on a sway-referenced
surface). INTERPRETATION: The review showed that the peripheral sensory
neuropathy hypothesis may not be the only fundamental cause accounting for
significant increased postural sway in individuals with diabetic neuropathy.
Visual impairments and changes in postural coordination may explain the
divergence between expectations and results. In order to develop interventions
aimed at improving postural control in individuals with diabetic neuropathy,
scientific exploration of these new expectations should be detailed. Also at the
practical level, the review discussed which additional sensory information - at
the level of the hands and feet - may be more beneficial in individuals with
diabetic neuropathy to reduce their postural sway.
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Langue : ANGLAIS