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Association between symptoms of bilateral numbness and/or paresthesia in the feet and postural instability in Japanese patients with diabetes.

ABSTRACT: Aim:This study assessed the association between symptoms of bilateral numbness and/or paresthesia in the feet and postural instability in Japanese patients with diabetes. Methods:This cross-sectional study included 303 patients with diabetes, aged 40-88 years, who were referred to an outpatient diabetic clinic between January and July 2013 at Shiga University of Medical Science Hospital. A posturography test was used to evaluate postural sway in patients. Indices of postural sway were the total length and the enveloped area. Analysis of covariance was used to estimate the multivariable-adjusted means of indices of postural sway according to the presence or absence of symptoms of bilateral numbness and/or paresthesia in the feet. Results:Of 303 patients, 35 (11.6 %) had symptoms of bilateral numbness and/or paresthesia in the feet. After adjustment for age, sex, diabetic retinopathy, regular exercise, body mass index, hemoglobin A1c level, and quadriceps' strength, patients with symptoms had higher levels of postural sway length and an enveloped area in the posturography test than those without symptoms. In addition, we observed similar results when we analyzed 234 patients aged ?60 years. Conclusions:Our findings suggest that patients who had symptoms of bilateral numbness and/or paresthesia in the feet may have more postural instability than those without symptoms.

SUBMITTER: Morimoto A

PROVIDER: S-EPMC6224907 | biostudies-other | 2016 Mar

REPOSITORIES: biostudies-other

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Association between symptoms of bilateral numbness and/or paresthesia in the feet and postural instability in Japanese patients with diabetes.

Morimoto Akiko A Sonoda Nao N Ugi Satoshi S Morino Katsutaro K Sekine Osamu O Nemoto Ken-Ichi KI Ogita Mihoko M Tatsumi Yukako Y Murata Shin S Maegawa Hiroshi H Miyamatsu Naomi N

Diabetology international 20150524 1

<h4>Aim</h4>This study assessed the association between symptoms of bilateral numbness and/or paresthesia in the feet and postural instability in Japanese patients with diabetes.<h4>Methods</h4>This cross-sectional study included 303 patients with diabetes, aged 40-88 years, who were referred to an outpatient diabetic clinic between January and July 2013 at Shiga University of Medical Science Hospital. A posturography test was used to evaluate postural sway in patients. Indices of postural sway ...[more]

PMID: 30603245

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Project description:BACKGROUND:Children and young people make up an age group most vulnerable to falls. Various stability disorders may become instrumental in sustaining more frequent falls and resultant fractures. Correct morphological structure impacts overall efficiency of the foot, as well as offers significant diagnostic potential. Even minor foot disorders may affect the entire bio kinematic chain, also impacting the foot's motility. Structural alterations within a foot may also impair balance in the standing position, and contribute to more frequent injuries. The study aimed to assess the relationship between feet deformities and postural stability deficits in schoolchildren prone to sustain accidental falls. METHODS:The study involved 200 children (101 girls and 99 boys) aged 10-15?years, randomly selected from primary schools. A 2D podoscan was used to assess the plantar part of the foot, while stabilometric examination was aided by the FreeMed dynamometric platform. RESULTS:Correlation between respective variables was reflected by Spearman's rank coefficient. The subjects' age negatively correlated with the COP range of movement along the Y axis, and the COP surface area, while their BMI negatively correlated with the COP trajectory's length. Step regression analysis indicated that the width of the left foot, the left foot Wejsflog index, the left foot Clark's angle, the hallux valgus angle were the essential predictors of stabilometric variables in girls. In boys, though, predictive value was associated with Clarke's angle of the left and right foot, Wejsflog index of the right foot, and the width of both the left and right foot. CONCLUSIONS:There is a statistically significant correlation between morphological variables of the foot and postural stability. When assessing the key variables of the foot and their interrelationship with postural stability, the Clarke's angle, Wejsflog index, hallux valgus angle, and foot width, should be granted due prominence in the girls. As regards the boys, the following variables were established as predictive in assessing postural stability: Clarke's angle, Wejsflog index, and foot width.

Project description:BackgroundPostural instability is an intractable sign of Parkinson's disease, associated with poor disease prognosis, fall risk, and decreased quality of life.Objective1) Characterize verbatim reports of postural instability and associated symptoms (gait disorder, balance, falling, freezing, and posture), 2) compare reports with responses to three pre-specified questions from Part II of the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS), and 3) examine postural instability symptoms and MDS-UPDRS responses as predictors of future falls.MethodsFox Insight research participants reported their problems attributed to PD in their own words using the Parkinson Disease Patient Reports of Problems (PD-PROP). Natural language processing, clinical curation, and data mining techniques were applied to classify text into problem domains and clinically-curated symptoms. Baseline postural instability symptoms were mapped to MDS-UPDRS questions 2.11-2.13. T-tests and chi-square tests were used to compare postural instability reporters and non-reporters, and Cochran-Armitage trend tests were used to evaluate associations between PD-PROP and MDS-UPDRS responses; survival methods were utilized to evaluate the predictive utility of PD-PROP and MDS-UPDRS responses in time-to-fall analyses.ResultsOf participants within 10 years of PD diagnosis, 9,692 (56.0%) reported postural instability symptoms referable to gait unsteadiness, balance, falling, freezing, or posture at baseline. Postural instability symptoms were significantly associated with patient-reported measures from the MDS-UPDRS questions. Balance problems reported on PD-PROP and MDS-UPDRS 2.11-2.13 measures were predictive of future falls.ConclusionVerbatim-reported problems captured by the PD-PROP and categorized by natural language processing and clinical curation and MDS-UPDRS responses predicted falls. The PD-PROP output was more granular than, and as informative as, the categorical responses.

Dataset Information

Association between symptoms of bilateral numbness and/or paresthesia in the feet and postural instability in Japanese patients with diabetes.

Publications

Association between symptoms of bilateral numbness and/or paresthesia in the feet and postural instability in Japanese patients with diabetes.

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