Functional Reach Test evaluated by wireless surface electromyography: a non-invasive assessment of fall risk in diabetic patients

This study analyzed the Functional Reach Test used in the clinical practice to identify elderly subjects at risk of recurrent falls. This study was designed to assess the fall risk in diabetic neuropathic subjects by means a non-invasive analysis of muscle activation patterns involved in the FR test using a wireless surface electro-myography. A population of diabetic non-neuropathic subjects was also considered, as control group for neuropathy. Surface electromyographic analysis of Sternocleido-mastoideus (Scm), Rectus Abdominis (RAbd), Erectores Spinae at L4 level (L4), Rec-tus Femoris (RF), Hamstrings (Ham), Tibialis Anterior (TA) and Soleus (Sol) was per-formed to this aim. In CTRL subjects, TA was identified as the first motor, since it activates before the start of FR period; its action can be attributed to the anticipatory muscular activity necessary to initiate the body forward displacement. Then, a caudo-cranial activation sequence of the anterior muscles was observed. Sol and Ham, fol-lowed by L4, act mainly as tonic muscles, opposing the movement and preventing falls. Compared to the CTRL group, the DN subjects show an anticipatory recruitment of TA. Results suggest that the anticipatory postural adjustment patterns exerted dur-ing the FR task and the earlier activation of TA in the diabetic neuropathic subjects could be the predictor of a greater propensity of this groups to the fall compared to di-abetic without neuropathy.