POSTURAL INSTABILITY IN DIABETIC NEUROPATHIC PATIENTS AT RISK OF FOOTULCERATION

Diabetic peripheral neuropathy is believed to cause postural instabili ty due to abnormal proprioception. We assessed body sway in four group s, each of 20 subjects, matched for age, sex, and BMI: non-diabetic co ntrols, non-neuropathic diabetic controls, subjects with diabetic neur opathy and no history of foot ulceration, and subjects with diabetic n europathy and a history of foot ulceration. Postural sway was assessed on a Kistler force plate using the Romberg test, measuring the standa rd deviation of the centre of pressure in both sagittal (antero-poster ior movement) and frontal (side to side movement) planes with eyes ope n and closed. The Romberg test results were log transformed and then a nalysed using analysis of Variance followed by Nevvman-Keuls test, The re was no significant difference in body sway between the two control groups and the first group of subjects with diabetic neuropathy. Howev er, in patients with a history of ulceration, values were significantl y higher (p < 0.05) compared to all other groups in both planes and co nditions studied. These results are suggestive of a relationship betwe en impaired body sway control and foot ulceration. Postural instabilit y may have clinical significance and increase the risk of minor trauma and ulceration in patients with diabetic neuropathy.