Hip strength: ankle proprioceptive threshold ratio predicts falls and injury in diabetic neuropathy

Muscle Nerve. 2014 Sep;50(3):437-42. doi: 10.1002/mus.24134. Epub 2014 Jan 20.

Abstract

Introduction: We determined lower limb neuromuscular capacities associated with falls and fall-related injuries in older people with declining peripheral nerve function.

Methods: Thirty-two subjects (67.4 ± 13.4 years; 19 with type 2 diabetes), representing a spectrum of peripheral neurologic function, were evaluated with frontal plane proprioceptive thresholds at the ankle, frontal plane motor function at the ankle and hip, and prospective follow-up for 1 year.

Results: Falls and fall-related injuries were reported by 20 (62.5%) and 14 (43.8%) subjects, respectively. The ratio of hip adductor rate of torque development to ankle proprioceptive threshold (Hip(STR) /AnkPRO ) predicted falls (pseudo-R(2) = .726) and injury (pseudo-R(2) = .382). No other variable maintained significance in the presence of Hip(STR) /AnkPRO .

Conclusions: Fall and injury risk in the population studied is related inversely to Hip(STR) /AnkPRO . Increasing rapidly available hip strength in patients with neuropathic ankle sensory impairment may decrease risk of falls and related injuries.

Keywords: accidental falls; aging; balance; diabetic neuropathy; mobility.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Ankle / physiology*
  • Data Interpretation, Statistical
  • Diabetic Neuropathies / complications*
  • Diabetic Neuropathies / epidemiology
  • Female
  • Hip / physiology*
  • Humans
  • Lower Extremity / physiology
  • Male
  • Middle Aged
  • Muscle Strength / physiology*
  • Neurologic Examination
  • Neuromuscular Diseases / physiopathology
  • Predictive Value of Tests
  • Proprioception / physiology*
  • Prospective Studies
  • Wounds and Injuries / epidemiology*