@article{ref1,
title="Diabetes and reactive balance: quantifying stepping thresholds with a simple spring  scale to measure fall-risk in ambulatory older adults",
journal="Journal of diabetes science and technology",
year="2020",
author="Rosenblatt, Noah J. and Young, Jennifer and Andersen, Ryley and Wu, Stephanie C. and Crews, Ryan T.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Fall-risk assessments for patients with diabetes fail to consider  reactive responses to balance loss. The purpose of this study was to assess the  feasibility of using a simple clinical tool to evaluate the impact of diabetes and  fall history on reactive balance in older adults. <br><br>METHODS: We recruited 72 older  adults with and without diabetes. Postural perturbations were applied by a  waist-mounted spring scale. Stepping thresholds (STs) in the anterior and posterior  directions were defined as the lowest spring-loads that induced a step. Balance was  assessed via the National Institutes of Health Toolbox Standing Balance Test, and  lower extremity sensation was assessed using vibratory perception threshold and  Semmes-Weinstein monofilaments. Fall history over the past year was self-reported. Cox regressions and analysis of variance were used to compare hazard rates for  stepping and observed STs between groups. <br><br>RESULTS: Anterior STs were elicited in 42  subjects and posterior STs in 65 subjects. Hazard rates for posterior ST were  significantly affected by diabetes, with greater hazards for fallers with diabetes  versus control fallers and nonfallers, after accounting for balance and sensory  loss. For those who stepped, ST was lower in the posterior direction for the  diabetes group. Additionally, anterior but not posterior ST was lower in all fallers  vs all nonfallers. <br><br>CONCLUSIONS: The waist-mounted spring scale is a clinically  implementable device that can assess ST in older adults with diabetes. Using the  device, we demonstrated that ST was affected by diabetes and could potentially serve  as a fall-risk factor independent of balance or sensory loss.<p /> <p>Language: en</p>",
language="en",
issn="1932-2968",
doi="10.1177/1932296820979970",
url="http://dx.doi.org/10.1177/1932296820979970"
}