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Volume 45 Number 9, 2008
   Pages 1441 — 1450

Abstract - Effects of vibrating insoles on standing balance in diabetic neuropathy

Juha M. Hijmans, MSc;1-2* Jan H. B. Geertzen, MD, PhD;1,3 Wiebren Zijlstra, PhD;2,4 At L. Hof, PhD;1-2,4 Klaas Postema, MD, PhD1-3

1Center for Rehabilitation, University Medical Center Groningen, 2School of Behavioral and Cognitive Neurosciences, 3Graduate School for Health Research, and 4Center for Human Movement Sciences, University of Groningen, Groningen, the Netherlands

Abstract — This study investigated the effects on standing balance of random vibrations applied to the plantar side of the feet by vibrating insoles in subjects with neuropathy and nondisabled subjects. In four different conditions (eyes open or closed and with or without an attention-demanding task [ATD]), subjects with neuropathy secondary to diabetes mellitus (n = 17) and nondisabled subjects (n = 15) stood for 60 s on vibrating insoles placed on a force plate. During each condition, the insoles were turned on for 30 s and off for 30 s (random order). The calculated balance measures were mean velocity of the center of pressure displacements and root-mean-square of the velocity of these displacements in the anteroposterior and mediolateral directions. In subjects with neuropathy, an interaction effect between vibration and an ADT was found for balance. No effects of vibration on balance were found in nondisabled subjects. Vibrating insoles improved standing balance in subjects with neuropathy only when attention was distracted. Improvement of the insoles and their activation is needed to make their implementation in daily living possible and effective.

Key words: balance, center of pressure displacement, diabetes mellitus, neuropathy, noise, postural instability, rehabilitation, standing balance, stochastic resonance, vibrating insoles.

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