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The Effect of Dual-Task Testing on Balance and Gait Performance in Adults with Type 1 or Type 2 Diabetes Mellitus: A Systematic Review

[ Vol. 17 , Issue. 5 ]

Author(s):

Humberto Omana*, Edward Madou, Manuel Montero-Odasso, Michael Payne, Ricardo Viana and Susan Hunter   Pages 10 - 26 ( 17 )

Abstract:


Background: Individuals with diabetes mellitus (DM) are susceptible to balance, gait and cognitive impairments. Importantly, diabetes affects executive function, a set of cognitive processes critical to everyday cortical function and mobility. Reduced executive function is a risk factor for falls in people with DM. Dual-task testing, the completion of two tasks at once, enables the examination of the cognitive-mobility relationship. A synthesis of the literature on the effects of dual- task testing on the balance and gait of individuals with DM has not been performed.

Objective: To systematically review the literature on the effect of dual-task testing on balance and gait in people with DM.

Methods: Databases EMBASE, CINAHL, MEDLINE, PsycINFO, Scopus and Web of Science were searched (inception-April 2020). Inclusion criteria: participants were adults with a diagnosis of DM, instrumented dual-task balance and/or gait was assessed, and articles were published in English.

Results: Ten articles met inclusion criteria- three examined dual-task balance and seven dual-task gait. In people with DM with or without peripheral neuropathy, dual-task resulted in larger sway velocities during standing tests. Individuals with DM and peripheral neuropathy had impaired dual-- task gait; specifically, and more consistently, reduced pace and rhythm compared to controls or people with DM without peripheral neuropathy.

Conclusion: The findings support a compromise in the cognitive-mobility relationship of people with DM, and especially in those with peripheral neuropathy. Future research should continue to examine the cognitive-mobility relationship in order to understand the increased prevalence of falls in this population.

Keywords:

Multitasking behavior, postural balance, gait, diabetes mellitus, aging, systematic review.

Affiliation:

Faculty of Health Sciences, University of Western Ontario, London, Ontario, School of Physical Therapy, University of Western Ontario, London, Ontario, Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Department of Physical Medicine & Rehabilitation, Parkwood Institute, London, Ontario, Canada;7Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Department of Physical Medicine & Rehabilitation, Parkwood Institute, London, Ontario, Canada;7Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Faculty of Health Sciences, University of Western Ontario, London, Ontario



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