title: Hip strength: ankle proprioceptive threshold ratio predicts falls and injury in diabetic neuropathy.
abstract: BACKGROUND
  We determined lower limb neuromuscular capacities associated with falls and fall-related injuries in older people with declining peripheral nerve function.
  
  
  METHODS
  Thirty-two subjects (67.4 ± 13.4 years; 19 with type 2 diabetes), representing a spectrum of peripheral neurologic function, were evaluated with frontal plane proprioceptive thresholds at the ankle, frontal plane motor function at the ankle and hip, and prospective follow-up for 1 year.
  
  
  RESULTS
  Falls and fall-related injuries were reported by 20 (62.5%) and 14 (43.8%) subjects, respectively. The ratio of hip adductor rate of torque development to ankle proprioceptive threshold (Hip(STR) /AnkPRO ) predicted falls (pseudo-R(2)  = .726) and injury (pseudo-R(2)  = .382). No other variable maintained significance in the presence of Hip(STR) /AnkPRO .
  
  
  CONCLUSIONS
  Fall and injury risk in the population studied is related inversely to Hip(STR) /AnkPRO . Increasing rapidly available hip strength in patients with neuropathic ankle sensory impairment may decrease risk of falls and related injuries.
authors.affiliation: University of Michigan, Physical Medicine and Rehabilitation, 325 E. Eisenhower Pkwy, Suite 400, Ann Arbor, Michigan, 48108.
authors.forename: James K
authors.initials: JK
authors.lastname: Richardson
authors.forename: Trina
authors.initials: T
authors.lastname: Demott
authors.forename: Lara
authors.initials: L
authors.lastname: Allet
authors.forename: Hogene
authors.initials: H
authors.lastname: Kim
authors.forename: James A
authors.initials: JA
authors.lastname: Ashton-Miller
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000502:physiology*; D003627:Data Interpretation, Statistical; D003929:Diabetic Neuropathies / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006615:Hip / Q000502:physiology*; D006801:Humans; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D009460:Neurologic Examination; D009468:Neuromuscular Diseases / Q000503:physiopathology; D011237:Predictive Value of Tests; D011434:Proprioception / Q000502:physiology*; D011446:Prospective Studies; D014947:Wounds and Injuries / Q000453:epidemiology*
keywords: accidental falls; aging; balance; diabetic neuropathy; mobility