Patient Story:
Mr. S, a 65-year-old gentleman, has managed type 2 diabetes for over 20 years with good control and no major complications. Despite his stable condition, he had never been tested for diabetic neuropathy. Recently, he noticed troubling changes: walking more slowly and feeling increasingly unsteady, though he hadn't fallen yet.
Recognizing these early warning signs, he came to our lab for a comprehensive balance assessment.
What We Discovered
Using the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), we uncovered significant balance deficits:
Visual Dependency:
- Marked instability when visual input was removed.
- Sway area exceeded 95% boundary limits of healthy individuals.
- Struggled severely on foam surfaces with eyes closed.
Postural Control Issues:
- Sway index much higher than age-matched healthy adults.
- Limits of Stability (LOS) revealed directional instability in multiple directions.
- Compromised ability to shift weight safely.
The data clearly showed impaired sensory feedback and heavy reliance on vision for stability - classic signs of developing diabetic neuropathy.
Immediate Safety Recommendations
- Daily foot inspection and proper protective footwear
- Remove home hazards like loose rugs, clutter and poor lighting
- Install grab bars in bathrooms and high-risk areas
- Ensure adequate lighting especially for nighttime navigation
- Use stable footwear and avoid walking barefoot
- Formal testing for diabetic sensory neuropathy
Balance Training Program
A targeted stability and balance drill program was designed to address his specific deficits. The program focuses on enhancing proprioceptive feedback, improving postural control and building confidence for daily activities.
Goals include reducing fall risk, improving independence and helping him maintain an active lifestyle despite early neuropathic changes.
Key Outcomes & Clinical Insights
- Early detection of balance issues before falls occur.
- Objective data revealed hidden sensory deficits not apparent in routine exams.
- Personalized safety plan addresses immediate fall prevention.
- Proactive approach helps maintain independence and quality of life.
Balance problems don't happen overnight. With comprehensive assessment, we detect subtle changes early and create targeted interventions that keep you steady, safe and confident in your daily activities.