Postural Rearrangement in IDDM Patients With Peripheral Neuropathy
- Pier Giorgio Giacomini, MD,
- Ernesto Bruno, MD,
- Glovanna Monticone, MD,
- Stefano Di Girolamo, MD,
- Antonio Magrini, MD,
- Leoluca Parisi, MD,
- Guido Menzinger, MD and
- Luigi Uccioli, MD
- Departments of Otolaryngology, Istituto di Ricovero e Cura a Carattere Scientifico Rome, Italy
- Endocrinology and Internal Medicine, University of Rome “Tor Vergata”, Istituto di Ricovero e Cura a Carattere Scientifico Rome, Italy
- Department of Neurology, University of Rome “La Sapienza”, Istituto di Ricovero e Cura a Carattere Scientifico Rome, Italy
- Istituto Dermopatico dell’ Immacolata, Istituto di Ricovero e Cura a Carattere Scientifico Rome, Italy
- Address correspondence and reprint requests to Pier Giorgio Giacomini, MD, Department of Otolaryngology, University of Rome “Tor Vergata,” c/o C.I. Columbus, Via Delia Pineta Sacchetti 506, 00168 Rome, Italy
Abstract
OBJECTIVE To evaluate the influence of diabetic peripheral neuropathy on postural strategy.
RESEARCH DESIGN AND METHODS Static posturography and nerve conduction velocity were performed in the following age-matched subjects: 10 IDDM patients with peripheral neuropathy, 23 IDDM patients without peripheral neuropathy, and 21 control subjects. All subjects with signs or symptoms of postural instability were excluded from the study. The following posturographic parameters were drawn: 1) velocity of body sway, expressed as mean velocity and average of the SDs, 2) VFY, the parameter derived from the velocity variance and the anteroposterior mean position of the body (this parameter monitors the postural strategy pursued by the subject), and 3) fast Fourier transformation on the x (FFTX) and y (FFTY) planes, spectral analysis of the frequencies of body oscillation on frontal (x) and anteroposterior (y) planes.
RESULTS Mean velocity and its SD were higher in IDDM patients with peripheral neuropathy than in control subjects and IDDM patients without peripheral neuropathy (P < 0.001). VFY was increased in IDDM patients with peripheral neuropathy versus control subjects and IDDM patients without peripheral neuropathy (P < 0.01). A direct relationship was found between parameters of posturography and some parameters of nerve conduction tests.
CONCLUSIONS Diabetic patients with peripheral neuropathy demonstrate a shift from physiological ankle control to hip postural control as monitored by specific posturography analysis.
- Received August 14, 1995.
- Accepted November 9, 1995.
- Copyright © 1996 by the American Diabetes Association
