Peripheral neuropathy, an independent risk factor for falls in the elderly, impairs stepping as a postural control mechanism: A case-cohort study.

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY Journal of the Peripheral Nervous System Pub Date : 2024-09-01 DOI:10.1111/jns.12656

Felix Kohle, Christopher Stark, Heinz-Dieter Klünter, Daniel Wernicke, Gilbert Wunderlich, Gereon R Fink, Jens P Klussmann, Michael Schroeter, Helmar C Lehmann

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Abstract

Background/aims: Peripheral neuropathies perturbate the sensorimotor system, causing difficulties in walking-related motor tasks and, eventually, falls. Falls result in functional dependency and reliance on healthcare, especially in older persons. We investigated if peripheral neuropathy is a genuine risk factor for falls in the elderly and if quantification of postural control via posturography is helpful in identifying subjects at risk of falls.

Methods: Seventeen older persons with a clinical polyneuropathic syndrome of the lower limbs and converging electrophysiology were compared with 14 older persons without polyneuropathy. All participants were characterized via quantitative motor and sensory testing, neuropsychological assessment, and self-questionnaires. Video-nystagmography and caloric test excluded vestibulocochlear dysfunction. For further analysis, all subjects were stratified into fallers and non-fallers. Overall, 28 patients underwent computerized dynamic posturography for individual fall risk assessment. Regression analyses were performed to identify risk factors and predictive posturography parameters.

Results: Neuropathy is an independent risk factor for falls in the elderly, while no differences were observed for age, gender, weight, frailty, DemTect test, timed "Up & Go" test, and dizziness-related handicap score. In computerized dynamic posturography, fallers stepped more often to regain postural control in challenging conditions, while the Rhythmic Weight Shift test showed a lack of anterior-posterior bidirectional voluntary control.

Interpretation: Our study confirms peripheral neuropathy as a risk factor for older persons' falls. Fallers frequently used stepping to regain postural control. The voluntary control of this coping movement was impaired. Further investigations into these parameters' value in predicting the risk of falls in the elderly are warranted.

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周围神经病变是老年人跌倒的一个独立风险因素，会损害作为姿势控制机制的步态：一项病例队列研究。

背景/目的：周围神经病会扰乱感知运动系统，造成行走相关运动任务的困难，最终导致跌倒。跌倒会导致功能性依赖和对医疗保健的依赖，尤其是在老年人中。我们研究了周围神经病变是否是老年人跌倒的真正风险因素，以及通过体位测量法量化姿势控制是否有助于识别有跌倒风险的受试者：将 17 名患有临床下肢多发性神经病综合征并伴有会聚电生理学的老年人与 14 名未患有多发性神经病的老年人进行比较。所有参与者都通过定量运动和感觉测试、神经心理评估和自我问卷调查进行了特征描述。视频滞后成像和热量测试排除了前庭耳蜗功能障碍。为了进一步分析，所有受试者被分为跌倒者和非跌倒者。总共有 28 名患者接受了计算机动态体位描记术，以进行个人跌倒风险评估。结果显示：神经病变是导致跌倒的独立风险因素：结果：神经病变是老年人跌倒的一个独立风险因素，而年龄、性别、体重、虚弱程度、DemTect测试、定时 "站起来走 "测试和头晕相关障碍评分均无差异。在计算机动态体位测量中，跌倒者在具有挑战性的条件下更频繁地迈步以恢复体位控制，而有节奏的重心移动测试表明他们缺乏前后双向的自主控制能力：我们的研究证实，周围神经病变是老年人跌倒的一个风险因素。跌倒者经常通过迈步来恢复姿势控制。这种应对动作的自主控制能力受到了损害。有必要进一步研究这些参数在预测老年人跌倒风险方面的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Peripheral Nervous System 医学-临床神经学

CiteScore

6.10

自引率

7.90%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.