Postural sway in individuals with type 2 diabetes and concurrent benign paroxysmal positional vertigo

ABSTRACT

Background and purpose: diabetes has been shown to affect the peripheral vestibular end organs and is associated with an increase in the frequency of benign paroxysmal positional vertigo (BPPV). People with diabetes have higher postural sway; however, the impact of symptomatic BPPV on postural sway in individuals with diabetes is unclear. The purpose of this cross-sectional study was to examine postural sway in people with type 2 diabetes who have symptomatic, untreated BPPV (BPPVDM). Methods: fifty-two participants (mean age 56.9 ± 5.6 years) were enrolled: controls (n = 14), diabetes (n = 14), BPPV only (n = 13) and BPPVDM (n = 11). An inertial motion sensor was used to detect pelvic acceleration across five standing conditions with eyes open/closed on firm/foam surfaces. Range of acceleration (cm/s²), peak velocity (cm/s) and variability of sway [root mean square (RMS)] in the anterior-posterior (AP) and medial-lateral (ML) directions were used to compare postural sway between groups across conditions. Results: participants with BPPVDM had higher ranges of acceleration in the AP (p = 0.02) and ML (p = 0.02) directions, as well as higher peak velocity (p < 0.001) and RMS values (p = 0.006) in the AP direction compared to the control and diabetes groups. Standing on foam with eyes closed and tandem stance were challenging conditions for people with BPPVDM. Conclusion: clinicians may consider using standing on foam with eyes closed and tandem standing with eyes open to assess postural control in people with BPPVDM to identify postural instability.

KEYWORDS:

• Postural sway
• type 2 diabetes
• symptomatic
• benign paroxysmal positional vertigo
• accelerometry

Acknowledgments

The authors would like to extend their sincere appreciation to the students at the University of Kansas Medical Center for their assistance with data collection, particularly Abdulghani Yahya, PhD student and Deidre Leist, DPT student.

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development [grant number T32HD057850]; the Kansas Partners in Progress grant, which is sponsored by the Kansas Physical Therapy Association; REDCap at the University of Kansas Medical Center is supported by CTSA [grant number CTSA Award # UL1TR000001] from NCRR and NCATS awarded to the University of Kansas Medical Center. The funding source had no involvement in the study process or publication decision.