Complex and Simple Clinical Reaction Times Are Associated with Gait, Balance, and Major Fall Injury in Older Subjects with Diabetic Peripheral Neuropathy.
James K Richardson, James T Eckner, Lara Allet and 2 others
PMID 27552354WHAT IT FOUND
In older adults with diabetic peripheral neuropathy, slower simple reaction time and less accurate complex reaction time were linked to shorter single-leg stance and uneven-surface step width variability; major injury data involved two DPN subjects.
Key findings
01Unipedal stance time correlated with simple latency (r = -.421, p = .005) and with the complex accuracy to simple latency ratio (r = .386, p = .011), but complex accuracy alone did not correlate significantly (r = .215, p = .172).
02Across all subjects, uneven surface step width range correlated with simple latency (r = .541, p = .001), complex accuracy (r = -.523, p = .002), and their ratio (r = -.709, p = .001).
03Two subjects with DPN sustained major injuries, and they had increased simple latency, decreased complex accuracy, and decreased ratio compared with DPN subjects without major injury; their mean ratio was about 2 standard deviations less.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was a secondary analysis with a small sample and no power calculations. Forty-two subjects were analyzed for stance time, but only 32 continued to gait and fall follow-up. Only 26 subjects had DPN and 16 did not, so group comparisons were unbalanced. Unipedal stance time was capped at 30 seconds, which may have hidden associations in participants without DPN. Only two subjects with DPN sustained major injury, so that finding may be chance and was not statistically analyzed. The reaction time device was not validated specifically in older adults with DPN. Mild cognitive impairment, mood, and personality traits were not formally assessed. The study reports associations, not proof that reaction time causes falls or that treatment changes outcomes.
Declared interests
The supplied metadata lists NIH extramural research support. The article text provided here does not include a conflicts-of-interest declaration.
The easy way to misread this
Do not conclude that slow or inaccurate reaction time causes falls or that this device is a validated clinical test. The major injury result involved only two subjects with DPN and was not statistically analyzed because of small numbers.