Addressing balance dysfunction in Peripheral Neuropathy

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Peripheral Neuropathy is a significant cause of balance deficits and associated falls. There are several types of peripheral neuropathy. Understanding the classification of peripheral neuropathy helps the physical therapist predict the associated symptoms and formulate a targeted treatment approach to effectively treat balance deficits arising from Peripheral Neuropathy.

This course looks at making the physical therapist aware of the different types of neuropathy, list and explain valid and reliable tests specific to neuropathies. The course also reviews the latest evidence based treatment to successfully treat the different kinds of peripheral neuropathies.

Duration: 4 hours

Instructor: Asha J Gummadi, PT, MS, NCS, CKTP.

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Eligible Participants

Physical Therapists, Physical Therapy Assistants, Students who are pursuing advanced Masters in Physical Therapy (MPT, MSPT).

Course Objectives:

Understand Balance Dysfunction
Identify Somatosensory Contribution to Balance
Familiarize with peripheral neuropathy and understand the variants of peripheral neuropathy.
Be able to predict symptoms based on the underlying sensory nervous system involved and formulate treatment approach around the identified deficit.
Present with research on correlation of vestibular dysfunction in several kinds of neuropathies.
Review the evidence based treatment approaches to effectively treat peripheral neuropathies.
Summarize the information with a case study example and provide examples of successful treatment plan.

References

"Peripheral Neuropathy Fact Sheet", NINDS, Publication date: August 2018.Retrieved September 29th,2019,from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet
Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care 2005;28(4): 956–62.
Gylfadottir SS, Weeracharoenkul D,Andersen ST,Niruthisard S et al.Painfula nd non-painfulplyneuropathy: Clinical characteristics and diagnostic issues. J Diabetes Investig 2019; 10: 1148– 1157 doi:1-.1111/jdi.13105.
Cohen HS, Stitz J, Mullavara AP, Peters BPT, Sangi-Haghpeyekar H, Kung DH, Mosier DR, Bloomberg JJ. Sharpening the tandem walking test for screening peripheral neuropathy. South Med J,2013 Oct;106(10):565-9. doi: 10.1097/SMJ.0000000000000009.
Moghtaderi A, Bakhshipour A, Rashidi H. Validation of Michigan neuropathy screening instrument for diabetic peripheral neuropathy. Clinical Neurology and Neurosurgery. 2006;108(5):477–481.
Comparison of different screening tests for diagnosis of diabetic peripheral neuropathy in Primary Health Care setting. Int J Health Sci (Qassim). 2012 Jun; 6(2): 127–134.
Perkins BA, Zinman B, Olyleye D, Bril V. Simple screening tests for peripheral neuropathy in the diabetic clinic. Diabetes Care. 2001;24(2):250–256.
Meijer, J. W. G., Smit, A. J., van Sonderen, E., Groothoff, J. W., Eisma, W. H., & Links, T. P. (2002). Symptom scoring systems to diagnose distal polyneuropathy in diabetes: the Diabetic Neuropathy Symptom score. Diabetic Medicine, 19(11), 962-965
C.J. DixonT. KnightE. BinnsB. IhakaD.O’Brien. Clinical measures of balance in people with type two diabetes: A systematic literature review. Gait & Posture 58 (2017) 325–332.
Horak FB, Jones-Rycewicz D, Black FO, Shumway-Cook A: Effects of vestibular rehabilitation on dizziness and imbalance. Otolaryngol Head Neck Surg 106:175–180, 1992
Strupp M, Arbusaw V, Maag KP, Gall C, Brandt T: Vestibular exercises improve central vestibulospinal compensation after vestibular neuritis. Neurology 51:838–844, 1998
Ites KI1, Anderson EJ, Cahill ML, Kearney JA, Post EC, Gilchrist LS. Balance interventions for diabetic peripheral neuropathy: a systematic review. J Geriatr Phys Ther . 2011 Jul-Sep;34(3):109-16. doi: 10.1519/JPT.0b013e318212659a.