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Advanced Neurology Neuropathy-reduced balance and gait

was significantly associated with decreasing V in MA but demonstrated a positive influence on the clinical symptoms
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with increasing V in LA, although the latter association of neuropathy. For instance, Tai Chi has been identified as a
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was not significant. This difference might be related to MA successful early intervention for individuals with moderate
having a much lower nerve conduction velocity compared reductions in foot sole sensitivity. Studies have reported
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to LA. In the absence of nerve conduction velocity improvements in foot sole sensitivity and functional gait,
reduction (LA), V would increase with the reduction including measures such as the 6MWD and TUG test, after
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of foot sole sensitivity. However, with the reduced 24 weeks of modified Tai Chi training. However, that
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conduction velocity (MA), movement control strategy study did not measure the H-index. Otherwise, it could be
and adaptation to the loss of foot sole sensitivity could suggested that there was an increase in H-index as well,
significantly differ. This phenomenon, where the H-index based on the positive correlation observed in LA between
mediates the relationship between functional outcomes H-index and 6MWD. Other studies have investigated
and foot sole sensation, is evident in Figure 4. Mediation the benefits of resistance and aerobic exercises 31-33 as
was apparent, as LA and MA correlations exhibit opposite well as postural control training for this population.
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patterns. Notably, the H-index-mediated relationship Exercise can positively affect postural control capacity and
between foot sole sensitivity and functional movements functional gait. Older adults are encouraged to participate
(both postural control and functional gait) has not been in exercise because it can help decrease the chances of a fall
previously reported in the literature. and interrupt the progression of the disease. Our results
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Nerve conduction velocity between MA and SA had a support the notion that exercise can help reverse the vicious
similar range (H-index was roughly in the 40 – 78 cm /ms cycle of PN and improve the life quality of individuals. 7
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range), and its correlation with V was different between There are a number of factors that may affect our
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groups. A decreased H-index was significantly correlated results. Individuals recruited for this study were either
with the increase of V in MA. This negative correlation healthy or diagnosed with diabetes, diabetic neuropathy,
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has been reported in the literature. However, within SA, or idiopathic neuropathy. The presence of diabetes can
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the decrease in nerve conduction velocity was significantly biologically affect the vestibular system. We do not know
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correlated with the increase in V . These two significant the potential effects of vestibular system deterioration on
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relationships indicate a foot sole sensitivity-mediated our postural control results. In addition, variables such
relationship between nerve conduction velocity and as time of day sensitivity and the number of steps taken
postural control since foot sole sensitivity was different have been shown to impact foot sole sensitivity, but these
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between MA (6 – 10) and SA (0 – 5). However, we did factors were not controlled in our protocol. Other factors
not observe foot sole sensitivity-mediated relationships that could influence the results of Hoffman’s reflex, such as
between H-index and functional gait in MA and SA, postural anxiety, fatigue, and possible oligosynaptic spinal
where both were in the same direction, although not cord pathways, were not controlled either. We also did not
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all were significant. Based on the observations from record the current medication intake of the participants,
Figures 4 and 5, nerve conduction velocity mediates the including medications that could affect falling. While
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relationship between foot sole sensitivity and both postural these factors should be better controlled in future studies,
control and functional gait, whereas foot sole sensation it is unlikely that they had a systematic effect on our
only mediates the relationship between H-index and observations due to the randomized nature of our data
postural control but not that of functional gait. collection process.
PN is a progressive disease, and its adverse effects on Ankle joint proprioception and leg strength have been
postural control and functional gait worsen over time. identified as factors affecting functional gait in individuals
1,23
Understanding the underlying reasons for PN-related with PN. Future research should compare the influences
movement disorders (e.g., loss of foot sole sensitivity of ankle joint proprioception and leg strength on clinical
or slowed nerve conduction velocity) allows for the outcome measures of functional gait in this population.
customization of training programs. Our results suggest This comparison can help us understand the influence
that better foot sole sensation positively affects postural of PN progression on ankle joint proprioception and
control and functional gait when nerve conduction strength. Furthermore, a more thorough investigation
velocity is not reduced. However, when there is a reduced of PN severity and extensive postural control ability
H-index, improved foot sole sensitivity does not yield (e.g., tandem walking or berg balance tests) is suggested
the same benefits. Therefore, early intervention may be to understand the severity of PN and dynamic postural
critical to reduce or reverse the effects of PN on postural control. The addition of more challenging tasks combined
control and functional gait. Specific types of exercises have with the effects of the deterioration of Hoffman’s reflex

Volume 3 Issue 2 (2024) 8 doi: 10.36922/an.2900