Comparison of balance ability between patients with type 2 diabetes and with and without peripheral neuropathy

PM R. 2014 Mar;6(3):209-14; quiz 214. doi: 10.1016/j.pmrj.2013.11.007. Epub 2013 Nov 18.


Objectives: (1) To examine the effects of peripheral neuropathy on balance stability in patients with type 2 diabetes, and (2) to assess static and dynamic balance and functional limitations.

Design: A cross-sectional study.

Setting: Outpatient clinic.

Patients: Subjects with type 2 diabetes and healthy subjects (n = 60) were divided into 3 groups: subjects with diabetes and with established peripheral neuropathy (diabetic peripheral neuropathy [DPN] group) (n = 17), subjects with diabetes and without peripheral neuropathy (diabetic control group) (n = 25), and subjects without diabetes (nondiabetic control [NDC] group) (n = 18).

Methods: Sensory impairment assessment, motor impairment assessment, and functional limitation assessment were assessed by using the Balance Master system.

Results: In motor impairment assessment, left-to-right directional control in the rhythmic weight shift was significantly poorer in the diabetic control group than in the NDC group during slow movement (P = .027). During fast movement, it was poorer in the DPN group than in the NDC group (P = .022). In the unilateral stance test of functional limitation assessment with both eyes open, the mean center of gravity sway velocity was significantly higher in the DPN group than in the NDC group (P = .011 for the left leg standing, P = .008 for the right leg standing) and higher in the DPN group than in the diabetic control group (P = .027 for the right leg standing). In the tandem walk test, walking speed was significantly lower in the DPN group than in the NDC group (P = .033), and end sway was significantly greater in the DPN group than in the NDC group (P = .020).

Conclusions: Analysis of the results of this study suggest that functional limitations may occur more in the patients with diabetes and with peripheral neuropathy, and dynamic balance stability may decrease more with the patients with diabetes than with the subjects without diabetes. Further studies on balance rehabilitation that concern dynamic balance stabilities and exercise abilities are needed in patients with diabetes.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetes Mellitus, Type 2 / rehabilitation
  • Diabetic Nephropathies / epidemiology
  • Diabetic Nephropathies / physiopathology*
  • Diabetic Nephropathies / rehabilitation
  • Exercise Test
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Leg / innervation*
  • Leg / physiopathology
  • Male
  • Middle Aged
  • Motor Activity / physiology*
  • Peripheral Nervous System / physiopathology*
  • Postural Balance / physiology*
  • Republic of Korea / epidemiology
  • Retrospective Studies