Medical Journal of The Islamic Republic of Iran (MJIRI)
Iran University of Medical Sciences
Thu, Jun 25, 2026
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Volume 40, Issue 1 (1-2026)
Med J Islam Repub Iran 2026 |
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Rahimzadeh S, Behdarvandan A, Mehrnoosh M, Orakifar N, Mofateh R, Hesam S et al . Postural Threat and Balance Control in Diabetic Neuropathy: Evidence from Anticipatory Postural Adjustments. Med J Islam Repub Iran 2026; 40 (1) :335-344
URL: http://mjiri.iums.ac.ir/article-1-10013-en.html
URL: http://mjiri.iums.ac.ir/article-1-10013-en.html
Shirin Rahimzadeh 
, Amin Behdarvandan , Mehrnoosh Mehrnoosh , Neda Orakifar , Razieh Mofateh , Saeed Hesam , Ramin Saki
, Amin Behdarvandan , Mehrnoosh Mehrnoosh , Neda Orakifar , Razieh Mofateh , Saeed Hesam , Ramin Saki
Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran & Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran , behdarvandan.a@ajums.ac.ir
Abstract: (142 Views)
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.
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.
Keywords: Anticipatory Postural Adjustment, Postural Threat, Diabetic Peripheral Neuropathy, Anxiety, Balance Control
Policy Review: Original Research |
Subject:
Physical Therapy
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