Vibration perception threshold in relation to postural control and fall risk assessment in elderly

Abstract

Purpose: This study investigates (i) the potential discriminative role of a clinical measure of peripheral neuropathy (PN) in assessing postural performance and fall risk and (ii) whether the integration of a simple screening vibration perception threshold (VPT) for PN in any physical (fall risk) assessment among elderly should be recommended, even if they do not suffer from DM. Method: One hundred and ninety-five elderly were entered in a four-group model: DM with PN (D+; n = 75), DM without PN (D−; n = 28), non-diabetic elderly with idiopathic PN (C+; n = 31) and non-diabetic elderly without PN (C−; n = 61). Posturographic sway parameters were captured during different static balance conditions (AMTI AccuGait, Watertown, MA). VPT, fall data, Mini-Mental State Examination and Clock Drawing Test were registered. Two-factor repeated-measures ANOVA was used to compare between groups and across balance conditions. Results: The groups with PN demonstrated a strikingly comparable, though bigger sway, and a higher prospective fall incidence than their peers without PN. Conclusions: The indication of PN, irrespective of its cause, interferes with postural control and fall incidence. The integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended.

Implications for Rehabilitation

• The indication of peripheral neuropathy (PN), irrespective of its cause, interferes with postural control and fall incidence.

• Therefore, the integration of a simple screening for PN (like bio-thesiometry) in any fall risk assessment among elderly is highly recommended.

• It might be useful to integrate somatosensory stimulation in rehabilitation programs designed for fall prevention.

• Diabetes mellitus
• elderly
• falls
• neuropathy
• peripheral
• postural control
• vibration perception threshold