Diagnostic strategy for diabetic polyneuropathy: Focus on nerve fiber type and magnetic resonance neurography

Wearable sensors-based postural analysis and fall risk assessment among patients with diabetic foot neuropathy

AIMS

To investigate the cross-sectional association between deep and superficial diabetic neuropathy, postural impairment assessed by wearable inertial sensors, and the risk of fall among patients with diabetic foot.

METHODS

Diabetic patients attending a University Podiatric Clinic were evaluated for the presence of deep and superficial peripheral neuropathy in sensory tests. Postural impairment was assessed using a wearable inertial sensor, and the evaluation of balance/gait and risk of fall was determined by the Tinetti Scale and Downton Index, respectively. Glycemic control was measured by glycated haemoglobin concentration and fasting glycaemia. The postural parameters measured were the anteroposterior and medio-lateral sway of the center of mass (CoM) and the sway area (area traveled by the CoM per second). The results were analyzed through a logistic regression model to assess those posture variables mostly significantly associated with neuropathy and risk of fall scales.

RESULTS

A total of 85 patients were evaluated. Spearman's rank correlation coefficients showed a strong and significant relationship (p < 0.05) between deep diabetic neuropathy assessed by Semmes-Weinstein monofilament, diapason and biothensiometer and postural alterations, whereas no significant correlations between superficial (painful sensitivity) neuropathy and the postural parameters. The sway path of the displacement along the anterior-posterior axis recorded during tests performed with eyes open and feet close together were significantly (p < 0.05) correlated with a poor glycemic (glycated haemoglobin concentration) control and each other with all diabetic neuropathy tests, fall risk scales, muscular weakness, ankle joint limitation and history of ulcers.

CONCLUSIONS

The results support the existence of a strong association between alterations of the deep somato-sensitive pathway (although depending on the tool used to measure peripheral neuropathy), glycemic control and balance impairments assessed using a wearable sensors. Wearable-based postural analysis might be part of the clinical assessment that enables the detection of balance impairments and the risk of fall in diabetic patients with diabetic peripheral neuropathy.

Pain and Stress Detection Using Wearable Sensors and Devices-A Review

Pain is a subjective feeling; it is a sensation that every human being must have experienced all their life. Yet, its mechanism and the way to immune to it is still a question to be answered. This review presents the mechanism and correlation of pain and stress, their assessment and detection approach with medical devices and wearable sensors. Various physiological signals (i.e., heart activity, brain activity, muscle activity, electrodermal activity, respiratory, blood volume pulse, skin temperature) and behavioral signals are organized for wearables sensors detection. By reviewing the wearable sensors used in the healthcare domain, we hope to find a way for wearable healthcare-monitoring system to be applied on pain and stress detection. Since pain leads to multiple consequences or symptoms such as muscle tension and depression that are stress related, there is a chance to find a new approach for chronic pain detection using daily life sensors or devices. Then by integrating modern computing techniques, there is a chance to handle pain and stress management issue.