Can Diabetes Dictate the Type of Feedback to be used to Control Body Sway in Elderly

Faris Alshammari, Eman Alzoghbieh, Fuad Al-Dabbak
Purpose:

The purpose of this study was to examine the effect of tactile feedback compared to visual feedback on body sway in elderly with diabetes compared to elderly without diabetes to determine the effect of diabetes on response to the mentioned interventions. 

Methods:

 Single-blinded randomized control trial was conducted. Subjects were assigned randomly into tactile feedback (TF) or visual feedback (VF) interventions as following: 10 EH and 12 ED received TF and 15 EH and 13 ED received VF. Balance platform was used to measure body sway pre and post intervention. CTSIB-M conditions were used on balance platform to measure body sway. The interventions were provided in 3 repetitions with 2 minutes of rest in between repetitions. Interventions were performed on hard surface in 2 repetitions of 2 minutes each and on compliant surface for 2 minutes. In TF, subjects were asked to close their eyes in the 2nd repetition of training. TF was provided through electrical stimulation (ES) at the highest point of distal third of the leg. ES was triggered if the subjects sway more than 75% of their average body sway. VF was provided through projecting the COP of the subjects on 52-inch screen and subjects were asked to maintain the COP within a circle.  Data was analyzed using mixed factorial ANOVA and analysis of covariance.


Results:

There was no significant difference in mean body sway between EH and ED groups on any of CTSIB-M conditions pre intervention or post intervention.  Results showed a significant reduction in body sway using TF in CTSIB-M condition 3 (1.0± .31 vs. 1.9± .8, p=.006) and condition 4 (1.8± .7 vs. 3.3± 1.5, p=.001) in EH. In ED, there was a significant reduction in body sway using TF in CTSIB-M condition 4 (1.4± .5 vs. 2.3± .8, p=.045) but not with condition 3. There was a significant reduction in body sway in ED using VF in CTSIB-M condition 3 (1.3 ± .5 vs. 2.1 ± 1.1; p=.018) and condition 4 (2.0 ± .8 vs 3.1 ± 2.1; p=.003). In the EH without diabetes, there was a significant reduction in body sway using VF in CTSIB-M condition 3 (1.4 ± .7 vs1.8 ± .9; p=.023), and condition 4 (1.9 ± .9 vs. 3.4 ± 1.8; p=.002).

Conclusion(s):

VF was more helpful than TF in controlling body sway in ED. TF showed better effect on controlling body sway in EH compared to ED. This can be attributed to possible peripheral sensory changes due to diabetes in ED.

Implications:

This study will help physical therapists in choosing the best feedback for elderly who suffer from increased body sway based on the presence of diabetes.

Funding acknowledgements:
Work was not funded.
Keywords:
Sway
Elderly
Feedback
Primary topic:
Neurology
Second topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Loma Linda University Medical Center
Provide the ethics approval number:
R3251-2018
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

Back to the listing