Balance and Motion Coordination Parameters Can be Improved in Patients With Type 2 Diabetes
Balance and Motion Coordination Parameters Can be Improved in Patients With Type 2 Diabetes
Diabetes mellitus type II (DMII) causes many complications, including retinopathy and
 peripheral neuropathy. These complications are well understood and believed to contribute to
 gait instability and increase the risk of falls. Poor balance control and increased falling
 risk have also been reported in people with diabetic peripheral neuropathy (DPN).

 Patients with DPN are at an increased risk of falling due to the decreased proprioceptive
 feedbacks. Effective balance training should improve instabilities of postural control in
 patients with DPN. For this purpose, evaluations and balance training was designed.

 The goal of our study was to establish values for proprioception, balance, muscle
 coordination and strength in patients with DMII, who underwent biofeedback balance training
 using the Biodex Balance System.
It is estimated that by the end of 2017 year, there will be 462 millions of patients
 suffering from diabetes mellitus type II (DMII), what is about 6% of world population (4,4%
 between 15 and 49 years of age, 15% between 50 and 69 years and 22% of patients older than 70
 years). It is predicted that by the beginning of 2030, number of cases on 100000 people will
 grow from 6059 up to 7079. There are studies proving that cardiovascular complications
 related to the diabetes are responsible for 4 millions of deaths annually. The newest
 epidemiological data suggest that growing number of DMII cases is no longer a problem in
 developed countries but also affects developing ones. As potential risk factors, well proved
 in the literature authors reported alcoholism, nicotinism, high body-mass index (BMI) and
 positive family history. It is therefore anticipated that the prevalence of one of its common
 complications, a diabetic peripheral neuropathy (DPN), will increase as well. It is broadly
 recognized that a DPN leads to a decrement in distal lower limb sensory function; however,
 there is also a neuropathy-related decrease in distal motor function, even among those with
 relatively mild diabetic disease. It is well proven in the literature, that diabetes mellitus
 influences negatively function of peripheral nervous system by damaging sensory fibers. A
 high risk of falls has been reported in the diabetic population, with an overall incidence of
 1.25 falls/person-year.It was proven that short-period strength and balance exercises do not
 improves diabetic patients quality of life However they have positive influence on the
 functional outcome of those people. Influence of DMII on motion system is not limited only to
 the peripheral nervous system. It also affects structures of cerebrum such as: cerebral
 cortex, cerebellum or basal nuclei. DMII affects motor and somatosensory cerebral atrophy
 what leads to changes in projection tracts associated with them. In cerebellum it affects on
 the vermis and parts of lobes responsible for receiving impulses from the spinal cord and
 controlling proximal parts of muscles, which are crucial for movement coordination during
 gait. Disorders caused by DMII in basal nuclei result in longer response time and slower gait
 velocity. Together with pharmacological and dietary interventions, exercise interventions
 including resistance training, represent the cornerstones of type 2 diabetes management. In
 addition to the beneficial effects of exercise interventions on glycemic control and on the
 cardiovascular risk factors associated with type 2 diabetes, physical exercise is an
 effective intervention to improve muscle strength, power output, cardiovascular function and
 functional capacity in elderly diabetic patients. In elderly diabetics with severe functional
 decline, multicomponent exercise programs composed of resistance, endurance, balance and gait
 retraining should be employed to increase functional capacity and quality of life and to
 avoid disability and falls. The aim of the study was to evaluate balance and motor
 coordination parameters in patients treated for type 2 diabetes who received
 biofeedback-equivalent training using the Biodex dynamometric platform.
Inclusion Criteria:

 -  willingness to participate in the study

 -  age over 65

 -  diagnosed type 2 diabetes, subjected to pharmacological treatment (study group)

 -  no type 2 diabetes (control group)

 Exclusion Criteria:

 -  unwillingness to participate in the study

 -  age below 65 years

 -  surgical intervention in the lower limbs or spine during the last 6 months

 -  symptoms of osteoarthritis or pain of another origin around the lower limbs or spine

 -  rheumatic diseases (eg. rheumatoid arthritis, ankylosing spondylitis)

 -  diagnosed neuromuscular disease

 -  strongly manifested imbalances due to impairment of central or peripheral nervous
 system

 -  neurological disorders with dizziness, nystagmus, dermatologic or profound
 (cerebrospinal syndrome, dizziness, multiple sclerosis, Parkinson's disease, etc.).