The effect of feet position on standing balance in patients with diabetes

Mahboobeh Mehdikhani; Nafiseh Khalaj; Tze Y Chung; Mazlina Mazlan

doi:10.1177/0954411914547714

The effect of feet position on standing balance in patients with diabetes

Proc Inst Mech Eng H. 2014 Aug;228(8):819-23. doi: 10.1177/0954411914547714.

Authors

Mahboobeh Mehdikhani¹, Nafiseh Khalaj², Tze Y Chung³, Mazlina Mazlan³

Affiliations

¹ Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia smehdikhani@gmail.com.
² Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.
³ Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

PMID: 25205748
DOI: 10.1177/0954411914547714

Abstract

Feet displacement is recognized to be an important element in standing and is also linked to postural instability in elderly people with diabetes. This study investigates standing balance in diabetic patients in four asymmetric feet displacements. Quiet standing balance was investigated using the Biodex Balance System in 18 diabetic patients and compared with 18 control elderly subjects. The four standing conditions, namely, comfortable feet position, preferred feet position with a stance width of 17 cm and 15° angle between the medial borders, feet side by side, and heel side by side with a 30° angle between medial edges of feet were evaluated (i.e. eyes opened, eyes closed). The overall stability was calculated by measuring anterior-posterior and medial-lateral indices in standing conditions. Differences among feet positions were compared using an analysis of variance and the independent t-test. The diabetic patients were unstable in the medial-lateral direction when standing with feet side by side versus heel side by side with a 30° angle between medial edges of feet (p = 0.012 and 0.011, respectively), while in controls the anterior-posterior stability scores between standing in preferred foot position with stance width of 17 cm and 15° angle between the medial borders versus feet side by side, and heel side by side with a 30° angle between medial edges of feet versus preferred foot position with stance width of 17 cm and 15° angle between the medial borders had significant difference (p < 0.05). The anterior-posterior stability scores of diabetic subjects with feet side by side versus comfortable foot position (p = 0.047) and heel side by side with a 30° angle between medial edges of feet versus comfortable foot position (p = 0.016) when they closed their eyes during the test had significant difference. Results confirmed that diabetic patients have greater instability in the medial-lateral direction when the base of support reduces and visual clue has an important role in standing balance.

Keywords: Stability; balance; feet displacement; standing.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Biomedical Engineering / instrumentation
Case-Control Studies
Diabetes Mellitus / epidemiology
Diabetes Mellitus / physiopathology*
Female
Foot / physiology*
Humans
Male
Middle Aged
Postural Balance / physiology*
Posture / physiology*