Exercise improves gait, reaction time and postural stability in older adults with type 2 diabetes and neuropathy

S. Morrison, S.R. Colberg, H.K. Parson, A.I. Vinik

Journal of Diabetes and its Complications

Abstract

Aims

For older adults with type 2 diabetes (T2DM), declines in balance and walking ability are risk factors for falls, and peripheral neuropathy magnifies this risk. Exercise training may improve balance, gait and reduce the risk of falling. This study investigated the effects of 12 weeks of aerobic exercise training on walking, balance, reaction time and falls risk metrics in older T2DM individuals with/without peripheral neuropathy.

Methods

Adults with T2DM, 21 without (DM; age 58.7 ± 1.7 yrs) and 16 with neuropathy (DM-PN; age 58.9 ± 1.9 yrs), engaged in either moderate or intense supervised exercise training thrice-weekly for 12 weeks. Pre/post-training assessments included falls risk (using the physiological profile assessment), standing balance, walking ability and hand/foot simple reaction time.

Results

Pre-training, the DM-PN group had higher falls risk, slower (hand) reaction times (232 vs.219 ms), walked at a slower speed (108 vs. 113 cm/s) with shorter strides compared to the DM group. Following training, improvements in hand/foot reaction times and faster walking speed were seen for both groups.

Conclusions

While falls risk was not significantly reduced, the observed changes in gait, reaction time and balance metrics suggest that aerobic exercise of varying intensities is beneficial for improving dynamic postural control in older T2DM adults with/without neuropathy.

http://www.sciencedirect.com/science/article/pii/S1056872714001226

Prosthetist Vacancies - Opcare - Roehampton, Newcastle & Cambridge

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Clinical Audit Awareness Week

HQIP is pleased to confirm details of this year's Clinical Audit Awareness Week(CAAW) webex sessions. The free, interactive lunchtime webinars have this year been designed around the classic Clinical Audit Cycle and will run everyday during CAAW from 20-24 October 2014 at 1-1.30pm. 

Further details can be found on the following link:

http://www.hqip.org.uk/clinical-audit-awareness-week-webinar-booking/?utm_medium=email&utm_campaign=eBulletin+2014-10-21&utm_content=eBulletin+2014-10-21+CID_b2634dcb0e3ad84bd86cd3c4cdc7527c&utm_source=ebulletin&utm_term=Its%20Clinical%20Audit%20Awareness%20Week

Trulife - Orthotist - North West London & The North West/Midlands

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Opcare Job Advertisement - 3 x Orthotist positions, England

To find out further information on the positions available please click on the following link:

Opcare Orthotist Positions, England

UNISON NHS Agenda for Change Action

UNISON is asking it's NHS employed members to take industrial action over NHS pay offer.  There will be strike action from 7am-11am on Monday 13 October 2014 followed by 4 days of action short of strike action from 14 October – 17 October. 

UNISON asks that if a member is employed directly by an NHS organisation on Agenda for Change terms and conditions then they are covered by the action and able to show support.  Members who choose to strike would lose pay as a result.

If a member is self employed, or employed under a contract for services, then they are not covered by the action. If this is the case we would ask that they do not cross picket lines or cover the work of striking workers. These BAPO members cannot be asked to strike or take action short of strike action. 

It is unlikely that any workplaces will close as a result of the strike however if so then any BAPO members should be informed by their employer and receive their full normal pay.
 
UNISON and other trade unions will likely be maintaining picket lines at entrances to workplaces. Pickets are allowed to peacefully persuade workers and others not to cross the picket line but anyone who decides to cross must be allowed. Anyone crossing the picket line will also likely be asked to not undertake any duties of to cover those who are on strike. 

Of course it is an individual decision and BAPO members can explain that they have not been balloted and are not on strike.  

The background to the strike is here http://www.unison.org.uk/at-work/health-care/key-issues/nhs-pay/home/ . 

BAPO Conference & Exhibition 2015 - Call for Posters

Ankle-foot orthoses in children with cerebral palsy: a cross sectional population based study of 2200 children

Ankle-foot orthosis (AFO) is the most frequently used type of orthosis in children with cerebral palsy (CP). AFOs are designed either to improve function or to prevent or treat muscle contractures.

The purpose of the present study was to analyse the use of, the indications for, and the outcome of using AFO, relative to age and gross motor function in a total population of children with cerebral palsy. 

Methods: A cross-sectional study was performed of 2200 children (58% boys, 42% girls), 0-19 years old (median age 7 years), based on data from the national Swedish follow-up programme and registry for CP. To analyse the outcome of passive ankle dorsiflexion, data was compared between 2011 and 2012.

The Gross motor classification system (GMFCS) levels of included children was as follows: I (n = 879), II (n = 357), III (n = 230), IV (n = 374) and V (n = 355). 

Results: AFOs were used by 1127 (51%) of the children. In 215 children (10%), the indication was to improve function, in 251 (11%) to maintain or increase range of motion, and 661 of the children (30%) used AFOs for both purposes.

The use of AFOs was highest in 5-year-olds (67%) and was more frequent at lower levels of motor function with 70% at GMFCS IV-V. Physiotherapists reported achievement of functional goals in 73% of the children using AFOs and maintenance or improvement in range of ankle dorsiflexion in 70%. 

Conclusions: AFOs were used by half of the children with CP in Sweden.

The treatment goals were attained in almost three quarters of the children, equally at all GMFCS levels. AFOs to improve range of motion were more effective in children with a more significant decrease in dorsiflexion at baseline.

Author: Maria WingstrandGunnar HägglundElisabet Rodby-Bousquet
Credits/Source: BMC Musculoskeletal Disorders 2014, 15:327

http://7thspace.com/headlines/489888/ankle_foot_orthoses_in_children_with_cerebral_palsy_a_cross_sectional_population_based_study_of_2200_children.html

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