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Hip strength: Ankle proprioceptive threshold ratio predicts falls and injury in diabetic neuropathy



Introduction: We determined lower limb neuromuscular capacities associated with falls and fall-related injuries in older people with declining peripheral nerve function. Methods: Thirty-two subjects (67.4 ± 13.4 years; 19 with type 2 diabetes), representing a spectrum of peripheral neurologic function, were evaluated with frontal plane proprioceptive thresholds at the ankle, frontal plane motor function at the ankle and hip, and prospective follow-up for 1 year. Results: Falls and fall-related injuries were reported by 20 (62.5%) and 14 (43.8%) subjects, respectively. The ratio of hip adductor rate of torque development to ankle proprioceptive threshold (HipSTR/AnkPRO) predicted falls (pseudo-R2 = .726) and injury (pseudo-R2 = .382). No other variable maintained significance in the presence of HipSTR/AnkPRO. Conclusions: Fall and injury risk in the population studied is related inversely to HipSTR/AnkPRO. Increasing rapidly available hip strength in patients with neuropathic ankle sensory impairment may decrease risk of falls and related injuries. Muscle Nerve 50: 437–442, 2014