Postural rearrangement in IDDM patients with peripheral neuropathy

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. Ali 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) VPI, the parameter derived from the velocity variance and the anteroposterior mean position oi 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 oi 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 I 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). ii 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.