TY - JOUR
T1 - Fear of falling is prevalent in older adults with diabetes mellitus but is unrelated to level of neuropathy
AU - Kelly, Carolyn
AU - Fleischer, Adam
AU - Yalla, Sai
AU - Grewal, Gurtej S.
AU - Albright, Rachel
AU - Berns, Dana
AU - Crews, Ryan
AU - Najafi, Bijan
PY - 2013
Y1 - 2013
N2 - Background: Patients with diabetic peripheral neuropathy (DPN) demonstrate gait alterations compared with their nonneuropathic counterparts, which may place them at increased risk for falling. However, it is uncertain whether patients with DPN also have a greater fear of falling. Methods: A voluntary group of older adults with diabetes was asked to complete a validated fear of falling questionnaire (Falls Efficacy Scale International [FES-I]) and instructed to walk 20 m in their habitual shoes at their habitual speed. Spatiotemporal parameters of gait (eg, stride velocity and gait speed variability) were collected using a validated body-worn sensor technology. Balance during walking was also assessed using sacral motion in the mediolateral and anteroposterior directions. The level of DPN was quantified using vibration perception threshold from the great toe. Results: Thirty-four diabetic patients (mean ± SD: age, 67.6 ± 9.2 years; body mass index, 30.9 ± 5.7; hemoglobin A1c, 7.9% ± 2.3%) with varying levels of neuropathy (mean ± SD vibration perception threshold, 34.6 ± 22.9 V) were recruited. Most participants (28 of 34, 82%) demonstrated moderate to high concern about falling based on their FES-I score. Age (r = 0.6), hemoglobin A1c level (r = 0.39), number of steps required to reach steady-state walking (ie, gait initiation) (r = 0.4), and duration of double support (r = 0.44) were each positively correlated with neuropathy severity (P <.05). Participants with a greater fear of falling also walked with slower stride velocities and shorter stride lengths (r = -0.3 for both, P <.05). However, no correlation was observed between level of DPN and the participant's actual concern about falling. Conclusions: Fear of falling is prevalent in older adults with diabetes mellitus but is unrelated to level of neuropathy.
AB - Background: Patients with diabetic peripheral neuropathy (DPN) demonstrate gait alterations compared with their nonneuropathic counterparts, which may place them at increased risk for falling. However, it is uncertain whether patients with DPN also have a greater fear of falling. Methods: A voluntary group of older adults with diabetes was asked to complete a validated fear of falling questionnaire (Falls Efficacy Scale International [FES-I]) and instructed to walk 20 m in their habitual shoes at their habitual speed. Spatiotemporal parameters of gait (eg, stride velocity and gait speed variability) were collected using a validated body-worn sensor technology. Balance during walking was also assessed using sacral motion in the mediolateral and anteroposterior directions. The level of DPN was quantified using vibration perception threshold from the great toe. Results: Thirty-four diabetic patients (mean ± SD: age, 67.6 ± 9.2 years; body mass index, 30.9 ± 5.7; hemoglobin A1c, 7.9% ± 2.3%) with varying levels of neuropathy (mean ± SD vibration perception threshold, 34.6 ± 22.9 V) were recruited. Most participants (28 of 34, 82%) demonstrated moderate to high concern about falling based on their FES-I score. Age (r = 0.6), hemoglobin A1c level (r = 0.39), number of steps required to reach steady-state walking (ie, gait initiation) (r = 0.4), and duration of double support (r = 0.44) were each positively correlated with neuropathy severity (P <.05). Participants with a greater fear of falling also walked with slower stride velocities and shorter stride lengths (r = -0.3 for both, P <.05). However, no correlation was observed between level of DPN and the participant's actual concern about falling. Conclusions: Fear of falling is prevalent in older adults with diabetes mellitus but is unrelated to level of neuropathy.
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U2 - 10.7547/1030480
DO - 10.7547/1030480
M3 - Article
C2 - 24297984
AN - SCOPUS:84888991338
SN - 8750-7315
VL - 103
SP - 480
EP - 488
JO - Journal of the American Podiatric Medical Association
JF - Journal of the American Podiatric Medical Association
IS - 6
ER -