Ultrasonographic Achilles Tendon Measurements and Static and Dynamic Balance in Prediabetes

TL;DR

This study found that prediabetic patients have similar Achilles tendon size and balance to controls, but thicker tendons correlate with worse balance and higher fall risk.

Contribution

First study to investigate Achilles tendon thickness and balance in prediabetic patients, revealing novel correlations with fall risk.

Findings

Prediabetic patients showed no significant differences in Achilles tendon size compared to controls or diabetics.

Thicker Achilles tendons in prediabetic patients correlated with worse balance and higher fall risk.

Dynamic balance scores in prediabetic patients were intermediate but not statistically different from controls or diabetics.

Abstract

Background and Objectives: There is a lack of studies examining balance problems and Achilles tendon thickness in prediabetes despite their common occurrence in diabetes mellitus. The aim of this study was to evaluate Achilles tendon size and static and dynamic balance, as well as the role of the Achilles tendon in balance, in prediabetic patients. Materials and Methods: A total of 96 participants were divided into three groups: (1) the control group, consisting of participants without diabetes mellitus; (2) the prediabetes group; and (3) the diabetes mellitus group. Ultrasonographic measurements of Achilles tendon sizes (thickness, width and area) were performed. Dynamic balance was assessed using the Berg Balance Scale, and static balance (the Fall and Stability Indices) was assessed using a Tetrax device. The Self-Leeds Assessment of Neuropathic Symptoms and Signs was utilized to identify neuropathic pain. Results: In the prediabetes group, the median dynamic balance scores [54.0 (51.0–56.0)] were lower than those of the control group [55.0 (54.0–56.0)] but higher than those of the patients with diabetes mellitus [52.50 (49.0–54.25)]; however, this difference did not reach statistical significance. The ultrasonographic measurements of the Achilles tendon size were similar among the three groups. On the other hand, in the prediabetes group, a positive correlation was observed between the bilateral Achilles tendon anterior–posterior thickness and Fall Index score (p = 0.045), while a negative correlation was found between the left Achilles tendon anterior–posterior thickness and the Berg Balance Score (p = 0.045). Conclusions: In prediabetes, neither Achilles tendon size nor static or dynamic balance appears to be significantly affected. However, in prediabetic patients, increased Achilles tendon thickness appears to be associated with increased risk of falls and decreased balance.

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