Effect of Executive Function to Postural Control During Standing in People With Diabetes Mellitus—A Dual-task Study

Abstract

Objectives

To investigate the contribution of executive function to postural control in people with diabetes mellitus (DM) and age-matched healthy adults (HC) during a dual-task paradigm.

Design

A cross-sectional and observational study.

Setting

Hospital and research institute setting.

Participants

Ten patients diagnosed with DM (age, 58.9±10.3y; 4 women) and 10 HC (age, 62.1±11.9y; 7 women) were recruited. Key inclusion criteria for DM patients included: (1) the age ranges from 19 to 79 years; (2) can stand independently; and (3) no neuromuscular conditions, which influence the balance.

Interventions

To perform the virtual reality-based sensory organization test (SOT), participants were instructed to stand on the force plate with virtual reality goggles with a harness system. A foam pad was used for conditions with the uneven surface. An auditory Stroop test (AST) was administered concurrently in the dual-task condition.

Main Outcome Measures

To measure postural sway, root mean square values of rambling-trembling displacement decomposed from center of pressure were calculated through the MATLAB. The SOT scores were calculated to measure the postural sway contributed by individual sensory systems. The correctness of AST and the dual-task cost (DTC) of postural sway were calculated to assess the executive function. We hypothesized that the poorer executive function presented by lower correctness of AST and greater DTC can be observed in DM group as compared with HC group.

Results

When compared with HC group, the significantly lowered AST correctness was observed in the DM group. The significantly lowered DTC of SOT score regarding root mean square rambling in the anteroposterior direction was observed in the DM group when the vision dominates.

Conclusions

The lowered AST correctness in people with DM indicated the altered executive function through the dual-task paradigm. The postural control was not altered in the DM group as the lower DTC of SOT score was observed. In the dual-task paradigm, people with DM may apply greater cognitive resource involvement in postural control than in the secondary task.

Disclosures

none.