**Author details**

to balance, postural control, motor control, muscular force, movement limitations or sensory deficiency. The clinical evaluation should include neurological examination; special care should be taken to identify visual and vestibular disorders, and to assess static and dynamic postural control and gait. Standardized scales and questionnaires may be helpful to evaluate

136 Peripheral Neuropathy - A New Insight into the Mechanism, Evaluation and Management of a Complex Disorder

The simplest method to record postural sway uses a force plate to measure the feet centre of pressure on the platform. To modify the somatosensory and visual inputs, moving force platforms and visual surroundings have been designed. Gait analysis may include the measurement of joint kinematics and kinetics, electromyography, oxygen consumption and

Polyneuropathy modify the amount and the quality of the sensorial information that is necessary for motor control, with increased instability during both, upright stance and gait.

Patients with peripheral neuropathy may have decreased stability while standing and when subjected to dynamic balance conditions. During upright stance, compared to healthy subjects, recordings of the centre of pressure in patients with diabetic neuropathy have shown larger

Balance and gait difficulties are the most frequently cited cause of falling in all age and gender groups Epidemiological surveys have established that a reduction of leg proprioception is a

Patients with polyneuropathy who have ankle weakness are more likely to experience multiple

Elderly patients with diabetic peripheral neuropathy are more likely to report an injury during walking or standing, which may be more frequent when walking on irregular surfaces. Among other risk factors, the occurrence of falls may be significantly associated with lower extremity weakness, which can be measured by knee extension, ankle dorsiflexion, and chair stands, visual acuity of less than 6/12, lower extremity impairments and poly-pharmacy, among other

In patients with various forms of peripheral neuropathy, the use of a cane, ankle orthoses or touching a wall improved spatial and temporal measures of gait regularity while walking under challenging conditions. Additional hand contact of external objects may reduce postural

Studies evaluating preventive and treatment strategies through excercise that could improve balance in patients with polyneuropathy are scarce. However, evidence support that physical activity interventions that increase activity probably do not increase the risk of falling in patients with diabetic peripheral neuropathy, and in this group of patients, specific training

and injurious falls than are those without specific muscle weakness.

instability caused by a deficiency of one or more senses.

may improve gait speed, balance, muscle strength and joint mobility.

and to follow-up deficits that may be evident on daily life activities.

sway, as well as increased oscillation at 0.5-1 Hz.

foot pressures.

risk factor for falls.

factors.

Kathrine Jáuregui-Renaud

Instituto Mexicano del Seguro Social, México
