POSTURAL STABILITY OF DIABETIC-PATIENTS WITH AND WITHOUT CUTANEOUS SENSORY DEFICIT IN THE FOOT

Postural stability was measured in 50 patients classified into two dia betic groups: insulin-dependent diabetes mellitus (IDDM: n = 27), and diabetic patients with bilateral cutaneous sensory deficit in the foot (CD: n = 23). All patients were matched to 50 non-diabetic controls o n age, weight and gender variables. The integrity of cutaneous sensory information at the foot was assessed using a monofilament test. Stati c and dynamic balance was evaluated using an objective balance test in volving computer-controlled dual force platforms enclosed by a visual surround. The apparatus provided six test conditions designed to syste matically manipulate or eliminate visual, vestibular or somatosensory information. Scores for the six tests, and a derived composite balance score together with movement strategy scores were used for data analy sis. For all six tests and composite score CD patients revealed signif icant postural instability compared to controls. Additionally, the CD group recorded reduced strategy scores indicating an atypical shift fr om ankle to hip strategy movement as postural control was stressed. ID DM patient test scores were not significantly different from control d ata on any pairwise comparison. Results indicated significant balance loss associated with CD putting the individual at increased risk for f alling and compromising foot mechanics. (C) 1997 Elsevier Science Irel and Ltd.