Can wobble board training improve balance in the elderly and diabetic population with and without peripheral neuropathy

Aljawaee, Madawi ORCID: https://orcid.org/0000-0001-6317-6124 2024. Can wobble board training improve balance in the elderly and diabetic population with and without peripheral neuropathy. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Diabetes mellitus (DM) affects 537 million adults, and this number is expected to increase to 634 million by 2030. Long-term, exposure to diabetes can result in diabetic peripheral neuropathy (DPN), which is characterised by a progressive deterioration of the sensorimotor system. It leads to neurogenic muscle atrophy and loss of muscle strength, ultimately contributing to impaired balance and an increased risk of falling. Thus, there is a need to lower the fall risk of people with diabetes (PWD), particularly those with DPN, since fall-related injuries can significantly affect quality of life and associated treatment costs. Therefore, a wobble board (WB) training programme was suggested, which is proven to improve balance in young adults and athletes. Three studies were conducted to investigate the effectiveness of WB training. The first study used a systematic literature review to determine the effectiveness of WB training for improving balance in healthy elderly individuals. The result of this review was a recommendation to assess WB improvement via a multi-modal assessment. The second study investigated the effect of biological sex, anthropometrics, footwear, physical activity and DT on static balance and WB performance in healthy adults, to provide normal values for use. The findings of this study indicate that females outperform males with respect to balance. The Wilcoxon test was used to test the differences between singles and DT, as well as between with and without footwear. In both sexes, footwear and DT has a minimal influence on static balance and WB performance, except during double leg stance with eyes close (DLSEC), static balance performance was better without footwear than with footwear in both sexes, but with footwear resulted in better static balance performance and WB performance during single leg stance (SLS) in males only, with no large effect size (the large ES ≥0.9 or ≤ -0.9). Being taller, heavier or having a larger upper torso are associated with poorer static balance and WB performance. The third study determined the effects of age, anthropometrics, severity of DPN, neuropathic pain, duration of DM, balance confidence, muscle strength and physical activity on static balance and on WB performance among PWD and individuals with DPN. Spearman’s rho correlation test was used to determine the relationship iii between previous baseline characteristics and static balance, as well as WB performance. Overall, anthropometrics factors affect static balance and WB performance. By benefitting from previous studies and their findings, a progressive, six-weeks WB training programme for PWD and individuals with DPN was implemented. The programme’s effect on static balance, WB performance, severity of DPN, neuropathic pain, balance confidence, muscle strength and physical activity were investigated. Positive results (P-value ≤ 0.001) were achieved after six weeks in terms of improved most of the previous factors, with large effect size. It is concluded that WB training is successful in improving sensorimotor system, which is responsible for controlling balance.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Engineering
Uncontrolled Keywords:	1). Wobble board 2). Balance exercises 3). Diabetic neuropathy 4). Older adults 5). Dynamic balance 6). Perturbation
Date of First Compliant Deposit:	21 March 2025
Last Modified:	21 Mar 2025 13:53
URI:	https://orca.cardiff.ac.uk/id/eprint/176898

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