Our office provides a thorough evaluation of a patient's lower extremity function including a gait exam to determine balance and stability.
Patients who are diabetic are at a greater risk for falls. There are many factors that can lead to the loss of balance in diabetics, and that is why fall prevention is very important for patients dealing with this progressively debilitating disease. Our office provides a thorough evaluation of a patient's lower extremity function including a gait exam to determine balance and stability. Falls can occur from diabetic neuropathy, lower gait velocity, decreased cadence, shorter stride length, increased time in STANCE Phase during the gait (walking) cycle, higher step-to-step variability, less ankle joint power, uncoordinated action of muscle activity (on-off).
The truth about falls:
- Postural stability with ankle support prevents falls.
- Falls account for one-third of the deaths in people over 65-year-old.
- People walking in the house with socks only are 11 times more likely to fall then if they are wearing the proper shoes.
- Falls are the leading cause of fatal and non-fatal injury among senior citizens in the United States.
- Falls cost the American Health Care System roughly $30 Billion anually.
- Roughly 2.5 million fall injuries occur yearly in the United States and require some sort of hospitalization.
As one ages, one becomes slower in cognitive processing, postural reaction, and has decreased muscle strength. In diabetics, this effect is amplified greatly. Falls in diabetics are frequent, and include neuropathy (sometimes in a vicious cycle where neuropathy will worsen over time). Diabetics are encouraged to attend exercise sessions to help improve function. Doing exercise sessions of balance/posture components (stretches, leg/lower back, and ab exercises) and resistance training (strength exercises with weights) leads to improved joint proprioception along with increased hamstring/quad strength and ultimately leading to decreased chances one would fall.
When beginning a program, all patients should monitor their blood glucose before, during and after exercise if taking insulin or oral agents. Our office will help coordinate scheduling a physical therapy and provide assistive devices such as canes and walkers and custom lightweight ankle braces as needed to help prevent devastating falls. Patients with the following problems should be seen and assessed:
- Muscles weakness or dropfoot condition from strokes.
- Arthritis of the feet and ankles.
- Abnormal walking pattern.
- Pain in the ankle or foot joints.
The American Diabetes Association currently recommends 150 min/week of exercise at an intensity of 40–60% with no less than three days a week and never with more than two consecutive days without physical activity. Improved insulin sensitivity from an exercise bout lasts no more than 72 hours is critical that patients maintain a regular exercise schedule.
Balance and gait training for patients with diabetic peripheral neuropathy will help with postural instability, altered locomotion biomechanics, and lead to a decreased risk of falls, plantar ulceration, and limb amputation. Circuit training with gait and balance exercises will strengthen muscles and allow for improvement in functional and independent gait (walking) range of motion. Ankle and foot strengthening in balance exercises can also help improve by doing single-leg stands, and tandem standing time.
Body positioning is the key and supporting the ankle prevents fatigue. We provide custom fabricated ankle braces in some cases, which will help reduce the energy used by the body, increase a person's stride length, decrease their postural sway, and increase their walking speed. All of these things aid in preventing falls. Podiatrists are professionals when discussing, examining, and educating patients on their gait, or walk. If you have fallen recently or have balance instability, please contact Dr. Theall, Podiatrist for a full comprehensive and thorough evaluation to prevent a fall. Call us now to have a full exam performed for yourself or an elderly parent, who may be at risk.
For more information, contact our East Orange office at 973-673-FOOT (3668).