Article

The peripheral neuropathy of the lower limbs (PNLL) is an important cause of
balance and mobility impairment in older adults. The nerve conduction study (NCS)
is the gold standard for PNLL diagnosis. Aim of this work is to establish the
sensitivity (Sn) and the specificity (Sp) of the balance and mobility examination
for the PNLL in older adults.
This study consecutively recruited 72 participants
(>65years) who accessed to the clinical neurophysiology outpatient clinic for
suspected PNLL. Participants were given the NCS and four clinical tests. Mobility
was evaluated by the Timed Up and Go (TUG) test, the Performance Oriented
Mobility Assessment (POMA) and the de Morton Mobility Index (DEMMI). In addition
the Clinical Evaluation of Static Upright Stance (CELSIUS) scale was developed
for a selective evaluation of static balance. Based on the NCS, 36% of
participants had PNLL. The CELSIUS scale (cutoff: 19.5/24), the TUG test (cutoff:
9.6s) and the DEMMI scale (cutoff: 17.5/19) have high Sn (0.92/0.96), but low Sp
(0.28/0.43) for the PNLL in the older adult. POMA scale (cutoff: 14.5/16) has low
Sn (0.73), but acceptable Sp (0.85). In addition, CELSIUS, DEMMI and TUG negative
likelihood ratios are 0.13, 0.17 and 0.12, respectively. Balance and mobility
examination have high sensitivity for PNLL. CELSIUS score>19/24, DEMMI
score>17/19 or TUG time</=9.6s substantially reduce PNLL likelihood. These
clinical measures are thus recommended for ruling-out PNLL in the older adult.
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Langue : ANGLAIS