Medical Journal of the Islamic Republic Of Iran

en Postural Threat and Balance Control in Diabetic Neuropathy: Evidence from Anticipatory Postural Adjustments Physical Therapy Physical Therapy Original Research Original Research <div style="text-align: justify;">    Background: Postural threat can influence both emotional and motor responses, particularly in individuals with diabetic peripheral neuropathy (DPN), who exhibit impaired balance and increased fall risk. This study examined the effects of postural threat on anticipatory postural adjustments (APAs) and anxiety in people with DPN compared with healthy controls.    Methods: This quasi-experimental study included twenty-five participants with DPN and twenty-five healthy controls. All participants completed the rise-on-toes task under two conditions: threat and no-threat. Center of pressure (COP) and electromyographic (EMG) signals were collected using a force platform and wireless EMG system. Anxiety was measured before and during each condition. Nonparametric Mann–Whitney and Wilcoxon tests with false discovery rate (FDR) correction were used, and effect sizes ® were calculated for significant comparisons.    Results: Individuals with DPN showed greater anxiety P<0.001, r=0.75) and delayed APA onset (P<0.001, r=0.62) compared with healthy controls. Both groups exhibited higher anxiety and larger, faster COP and EMG responses under threat (P<0.001, r=0.50–0.70), but the magnitude of these adjustments was smaller in the DPN group.    Conclusion: Postural threat increased emotional arousal and APA magnitude in both groups, though individuals with DPN demonstrated attenuated adaptive modulation. These findings suggest that incorporating psychological and sensorimotor balance training may enhance stability and reduce fall risk in this population. </div> Anticipatory Postural Adjustment, Postural Threat, Diabetic Peripheral Neuropathy, Anxiety, Balance Control 335 344 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-9906-1&slc_lang=en&sid=1 Shirin Rahimzadeh shirinrahimzadeh69@gmail.com 200319475328460097397 200319475328460097397 No Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Amin Behdarvandan behdarvandan.a@ajums.ac.ir 200319475328460097398 200319475328460097398 Yes Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Mehrnoosh Mehrnoosh mehrnooshzakerkish@gmail.com 200319475328460097399 200319475328460097399 No Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Neda Orakifar nedaoraki@yahoo.com 200319475328460097400 200319475328460097400 No Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Razieh Mofateh mofatehr@yahoo.com 200319475328460097401 200319475328460097401 No Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Saeed Hesam saeed_hesam65@yahoo.com 200319475328460097402 200319475328460097402 No Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Ramin Saki ramin.saki74@gmail.com 200319475328460097403 0009-0007-2707-0737 No Department of Mechanics, Faculty of Engineering, Chamran University of Khuzestan, Ahvaz, Iran