Article

The aim of this work was to identify relationships between complex and
simple clinical measures of reaction time (RTclin) and indicators of balance in
older subjects with and without diabetic peripheral neuropathy (DPN). DESIGN:
Prospective cohort design. Complex RTclin accuracy, simple RTclin latency, and
their ratio were determined using a novel device in 42 subjects (mean +/- SD age,
69.1 +/- 8.3 yrs), 26 with DPN and 16 without. Dependent variables included
unipedal stance time (UST), step width variability and range on an uneven
surface, and major fall-related injury over 12 months. RESULTS: In the DPN
subjects, the ratio of complex RTclin accuracy to simple RTclin latency was
strongly associated with longer UST (R/P = 0.653/0.004), and decreased step width
variability and range (R/P = -0.696/0.001 and -0.782/<0.001, respectively) on an
uneven surface. Additionally, the 2 DPN subjects sustaining major injuries had
lower complex RTclin accuracy:simple RTclin latency than those without.
CONCLUSIONS: The ratio of complex RTclin accuracy:simple RTclin latency is a
potent predictor of UST and frontal plane gait variability in response to
perturbations and may predict major fall injury in older subjects with DPN. These
short latency neurocognitive measures may compensate for lower limb neuromuscular
impairments and provide a more comprehensive understanding of balance and fall
risk.

Langue : ANGLAIS