Sensory-Motor Mechanisms and falls risk in DPN patients

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From a recent paper Reeves et al 2021 https://doi.org/10.3390/medicina57050457

"Quote
. Falls in people with diabetes is actually an even greater clinical challenge—someone with DPN is up to 20-fold more likely to fall compared to an age matched non-diabetic control [5,6]. Studies have established DPN as a strong independent predictor of falls risk [7–11]. The clinical implications of DPN-related falls stretch well beyond the injurious consequences to include psychological distress [12], fear of falling [13] and curtailment of physical activities linked to unsteadiness [14]"

I had no idea of just how much more at risk of falling patients with DPN were .

 

Here is another quote from Reeves et al ,a fascinating ,and alarming ,paper -

"DPN-related unsteadiness is common, with a large-scale UK-USA study showing that
23% of the 484 patients with DPN perceived themselves as being unsteady, with associated
balance problems [15]. One of the symptoms most strongly predicting depression in
people with diabetes is DPN-related unsteadiness [12,15–17], highlighting its key role in
psychological distress. Patients do not always self-report their unsteadiness as a clinical
problem because they do not identify it to be caused by DPN, but rather incorrectly attribute
it to diminishing capacities as a result of ageing [12]. In fact, many DPN patients affected
by unsteadiness and falls are much younger than where ageing- and frailty-related falls
become prominent in the general ‘ageing’ population. This patient misconception and
lack of reporting leads to falls often being neglected as a clinical issue by both patients
and clinicians."

 

So perphheral neuropathy is a big problem in the diabetic foot and can contribute to a 20x risk of falls . " And ? " ,some might ask .

Well you can improve neuropathy with supervised targeted foot exercises . Here is another paper which demonstrates this .
If you can improve neuropathy then could you prevent it altogether with an early and diligently followed exercise routine ? Maybe not, but I feel this certainly needs looked at .
The effects of foot exercise with audiovisual and group support foot exercises to diabetes mellitus patients

Rohmatul Faizah 1, Ferry Efendi 1, Suprajitno Suprajitno 2
Affiliations expand

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• DOI: 10.1007/s40200-021-00756-9

Abstract

Objectives: This study aimed to analyze the effect of audiovisual and group support foot exercises on the Ankle Brachial Pressure Index and foot sensation.
Methods: This study used a quasi-experimental design. The sample number of this study was 156 using a purposive sampling technique. The research group was divided into three groups. The variables measured in this study were ABPI, foot sensation, and foot exercise experience. The statistical analysis was conducted by a paired-sample t-test, an independent-sample t-test, and a two-way Manova.
Results: The results showed that each group had a difference in how ABPI and foot sensation were influenced (p = 0.000). Additionally, audiovisual and group support foot exercises have been shown to influence ABPI (p = 0.000) and foot sensation (p) = 0.000).
Conclusions: Audiovisual and group support foot exercises significantly influenced the Ankle Brachial Pressure Index value and foot sensation in diabetic mellitus patients. This intervention is encouraged for diabetic mellitus patients who would like to see the benefits of exercise and group support.
Keywords: Ankle brachial pressure index; Foot exercises; Foot sensation; Group support.