The Effect of Plantar Sensitivity on Movement Control of Sit-to-Stand in Older Adults with Diabetes

  • 陳 宜紋

Student thesis: Master's Thesis

Abstract

Background and purpose: Diabetes mellitus (DM) is one of the major chronic diseases in the elderly population Chronic DM could result in peripheral neuropathy which begins with impaired plantar cutaneous sensation This impairment has been found to have negative effects on the ability to perform daily activities The five times sit-to-stand (FTSS) is a commonly used measure to reflect the functional capacity of older adults and has been shown to be a strong predictor of future functional loss The purposes of this study were first to investigate the differences in the control of FTSS between healthy and diabetic older adults with and without plantar insensitivity and further to determine to what extent sensorimotor function affected the FTSS performance Methods: Twenty-four healthy (CON) and 44 diabetic (DM) older adults participated in this study The DM subjects were further categorized into having plantar insensitivity (DM-PI n=22) or not (DM-nonPI n=22) according to the results of a plantar cutaneous sensation test using Semmes-Weinstein monofilaments For the FTSS subjects were instructed to stand up from a seated position and then sit back down for 5 repetitions consecutively at their maximal speeds An accelerometer with a sampling rate of 148 Hz was placed at the spinous process of the third lumbar vertebrae to measure the acceleration of body’s center of mass in the anterior-posterior (AP) and vertical directions The acceleration parameters were the range and standard deviation (SD) of the AP and vertical directions One-way ANOVAs were conducted to analyze the duration and acceleration of vertical and AP directions of total FTSS and each phase (sit-to-stand and stand-to-sit) of the five repetitions The percentages of total time in each repetition were analyzed by two-way repeated measure ANOVAs A multiple linear regression analysis was used to investigate the contribution of sensorimotor function on the performance of FTSS in DM patients Results: During the FTSS the overall range of vertical acceleration had significant group differences with smaller range in DM-PI than CON Compared the percentage of total time spent in each repetition the first repetition required significantly longer time than the other repetitions for all the subjects In the sit-to-stand phase the vertical acceleration range of DM-PI was significantly smaller than CON and DM-nonPI in the first and last repetitions smaller than CON in the second through fourth repetitions In the stand-to-sit phase the acceleration range and SD of the vertical direction in the second and third repetitions were significantly smaller in DM-PI than CON In the fourth repetition the range in DM-PI was significantly smaller than CON and DM-nonPI and the SD was also significantly smaller in DM-PI than CON After controlling for age gender and duration of diabetes knee extensors muscle strength added significant contributions to the FTSS total time Conclusion: Since acceleration is a reflection of how fast an individual changes movement velocity the smaller acceleration in diabetic older adults with plantar insensitivity indicated that these older adults had a reduced capacity in changing the velocity These changes in movement control could be a cautious strategy to compensate for poorer balance control related to plantar insensitivity
Date of Award2015 Jan 30
Original languageEnglish
SupervisorSang-I Lin (Supervisor)

Cite this

The Effect of Plantar Sensitivity on Movement Control of Sit-to-Stand in Older Adults with Diabetes
宜紋, 陳. (Author). 2015 Jan 30

Student thesis: Master's Thesis