Year 2019, Volume 5, Issue 4, Pages 697 - 706 2019-07-04

Effectiveness of balance training with kinesthetic ability trainer (KAT 2000) in patients with peripheral neuropathic pain: a randomised controlled study

Duygu Kerim [1] , Aslıhan Uzunkulaoğlu [2] , Saime Ay [3]

30 218

Objectives: The aim of this study isto determine the effectiveness of balance training with Kinesthetic Ability Trainer (KAT 2000) in patients with peripheral neuropathic pain related balance disorder.

Methods: Sixty patients were included into this controlled prospective study and randomized into either balance exercises group (Group 1) or KAT 2000 exercises group (Group 2). Balance exercises were given to all patients. Also, KAT 2000 balance exercises were given all patients in Group 2 (n = 30). All patients received 45-min individualized training session for three times a week for 4 weeks. Douleur Neuropathique 4 (DN4) questionnaire for neuropathic pain; visual analogue scale (VAS) for pain severity; KAT 2000 for static and dynamic balance; Nottingham Health Profile (NHP) for Quality of Life (QoL) was used. Dynamic balance and mobility also was assessed using the Berg Balance Scale (BBS) and Time Up and Go (TUG) test. Patients were evaluated at baseline and the end of the 4-week exercise program.

Results: At the end of the treatment; VAS, BBS, KAT 2000, TUG, NHP, physical activity, NHP pain, NHP social isolation and NHP emotional reactions scores improved significantly in both groups (p < 0.05) except NHP sleep and NHP energy level scores in balance exercises group (p > 0.05). Statistical differences in VAS pain on movement, global assessment of patient, global assessment of doctor, NHP energy level scores were found between the groups (p < 0.05); but there were no statistical difference in VAS at rest, VAS at night, BBS, KAT 2000, TUG, NHP physical activity, NHP pain, NHP sleep, NHP social isolation and NHP emotional reactions scores between the groups (p > 0.05).

Conclusion: When combined with the KAT 2000 device, positive effects of balance-coordination exercises on pain on movement and energy level are more evident in patients with peripheral neuropathic pain. 

Neuropathic pain, balance, KAT 2000, quality of life
  • [1] Jensen TS, Baron R, Haanpää M, Kalso E, Loeser JD, Rice AS, et al. A new definition of neuropathic pain. Pain 2011;152:2204-5.
  • [2] Meacham K, Shepherd A, Mohapatra DP, Haroutounian S. Neuropathic pain: central vs. peripheral mechanisms. Curr Pain Headache Rep 2017;21:28.
  • [3] Backonja MM, Serra J. Pharmacologic management part 1: Better studied neuropathic pain diseasese. Pain Med 2004;5:528-47.
  • [4] Gryfe CI, Amies A, Ashley MJ. A longitudinal study of falls in an elderly population: I. Incidence and morbidity. Age Ageing 1977;6:201-10.
  • [5] Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988;319:1701-7.
  • [6] Pack DR, Wolfson LI, Amerman P, Whipple R, Kaplan JG. Peripheral nerve abnormalities and falling in the elderly. Neurology 1985;35 Suppl 1:79.
  • [7] Van de Bosh C, Gilsing MG, Lee SG, Richardson JK, Ashton Miller JA. Peripheral neuropathy effect on ankle inversion and eversion thresholds. Arch Phys Med Rehabil 1995;76:850-6.
  • [8] Richardson JK, Ashton-Miller JA, Lee SG, Jacobs K. Moderate peripheral neuropathy impairs weight transfer and unipedal balance in the elderly. Arch Phys Med Rehabil 1996;77:1152-6.
  • [9] www.randomizer.org
  • [10] Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 2005;114:29-36.
  • [11] Unal Cevik I, Sarioglu Ay S, Evcik D. A comparison of the DN4 and LANSS questionnaires in the assessment of neuropathic pain: validity and reliability of the Turkish version of DN4. J Pain 2010;11:1129-35.
  • [12] Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L. Assessment of pain. Br J Anaesth 2008;101:17-24.
  • [13] Hunt SM, McEwen J. The development of a subjective health indicator. Sociol Health Illn 1980;2:231-46.
  • [14] McDowell I. Measuring health: a guide to rating scales and questionnaires. 3rd ed. Oxford University Press. 2006:pp. 780.
  • [15] O’Brien BJ, Buxton MJ, Ferguson BA. Measuring the effectiveness of heart transplant programmes: quality of life data and their relationship to survival analysis. J Chronic Dis 1987;40:S137-53.
  • [16] Hansen MS, Dieckmann B, Jensen K, Jakobsen BW. The reliability of balance tests performed on the kinesthetic ability trainer (KAT 2000). Knee Surg Sports Traumatol Arthrosc 2000;8:180-5.
  • [17] Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992;83(Suppl 2):S7-S11.
  • [18] Sahin F, Yilmaz F, Ozmaden A, Kotevolu N, Sahin T, Kuran B. Reliability and validity of the Turkish version of the Berg Balance Scale. J Geriatr Phys Ther 2008;31:32-7.
  • [19] Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142-8.
  • [20] Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000;80:896-903.
  • [21] Bohannon RW. Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther 2006;29:64-8.
  • [22] American College of Sports Medicine, Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 2009;41:1510-30.
  • [23] Valerio BC, Nobrega JA, Tilbery CP. Neural conduction in hand nerves and the physiological factor of age. Arq Neuropsiquiatr 2004;2:114-8.
  • [24] Perry MC, Carville SF, Smith IC, Rutherford OM, Newham DJ. Strength, power output and symmetry of leg muscles: effect of age and history of falling. Eur J Appl Physiol 2007;100:553-61.
  • [25] DeVita P, Hortobagyi T. Age increases the skeletal versus muscular component of lower extremity stiffness during stepping down. J Gerontol Ser A Biol Sci Med Sci 2000;55:B593-600.
  • [26] Nardone A, Godi M, Artuso A, Schieppati M. Balance rehabilitation by moving platform and exercises in patients with neuropathy or vestibular deficit. Arch Phys Med Rehabil 2010;91:1869-77.
  • [27] Horlings CG, Kung UM, Bloem BR, Honegger F, Van Alfen N, Van Engelen BG, et al. Identifying deficits in balance control following vestibular or proprioceptive loss using posturographic analysis of stance tasks. Clin Neurophysiol 2008;119:2338-46.
  • [28] Van Deursen RW, Simoneau GG. Foot and ankle sensory neuropathy, proprioceptionand postural stability. J Orthop Sports Phys Ther 1999;29:718-26.
  • [29] Allet L, Armand S, de Bie RA, Golay A, Monnin D, Aminian K, de Bruin ED. The gaitand balance of patients with diabetes can be improved: a randomised controlled trial. Diabetologia 2010;53:458-66.
  • [30] Frost, Lydia R., Brown, Stephen H.M. Muscle activation timing and balance response inchronic lower back pain patients with associated radiculopathy. Clinical Biomechanics 2016;32:124-30.
  • [31] Nardone A, Godi M, Artuso A, Schieppati M. Balance rehabilitation by moving platformand exercises in patients with neuropathy or vestibular deficit. Arch Phys Med Rehabil 2010;91:1869-77.
  • [32] Lindemann U, Rupp K, Muche R, Nikolaus T, Becker C. Improving balance byimproving motor skills. Z Gerontol Geriatr 2004;37:20-6.
  • [33] France P, Derscheid G, Irrgang J, Malone T, Petersen R, Tippett S et al. Preliminary clinical evaluation of the Breg K.A.T.: effects of training in normals. Isokinet Exerc Sci 1992;2:133-9.
  • [34] Crawford C, Fleming K, Karabatsos P, Volkmann C, Williams K, Newton R. Normative values for healthy young and elderly adult populations on the KAT balance system. Issues Aging 1995;18:10-4.
  • [35] Johnston RB, Howard ME, Cawley PW, Losse GM. Effect of lower extremity muscular fatigue on motor control performance. Med Sci Sports Exerc 1998;30:1703-7.
  • [36] Kruse RL, LeMaster JW, Madsen RW. Fall and balance outcomes after an intervention to promote leg strength, balance, and walking in people with diabetic peripheral neuropathy: “Feet First” randomized controlled trial. Phys Ther 2010;90:1568-79.
  • [37] Song CH, Petrofsky JS, Lee SW, Lee KJ, Yim JE. Effects of an exercise program onbalance and trunk proprioception in older adults with diabetic neuropathies. Diabetes Technol Ther 2011;13:803-11.
  • [38] Donoghue D; Physiotherapy Research and Older People (PROP) group, Stokes EK. Howmuch change is true change? The minimum detectable change of the Berg Balance Scale inelderly people. J Rehabil Med 2009;41:343-6.
  • [39] Shumway-Cook A, Brauer S, Woollacott M. Predicting the probabilityfor falls incommunity-dwelling older adults using the Timed Up & Go Test. Phys Ther 2000;80:896-903.
  • [40] David J. Rowbotham. Neuropathic pain and quality of life. European Journal of Pain 2002;6 (Suppl. B):19-24.
  • [41] Jensen MP, Chodroff MJ, Dworkin RH. The impact of neuropathic pain on health-relatedquality of life: review and implications. Neurology 2007;68:1178-82.
  • [42] O'Connor AB. Neuropathic pain: quality-of-life impact, costs and cost effectiveness of therapy. Pharmacoeconomics 2009;27:95-112.
  • [43] Benbow SJ, Wallymahmed ME, MacFarlane IA. Diabetic peripheral neuropathy and quality of life. OJM 1998;91:733-7.
Primary Language en
Subjects Health Care Sciences and Services
Journal Section Original Articles
Authors

Orcid: 0000-0003-3962-7612
Author: Duygu Kerim (Primary Author)
Institution: Department of Physical Medicine and Rehabilitation, Ufuk University School of Medicine, Ankara, Turkey
Country: Turkey


Orcid: 0000-0003-3575-725X
Author: Aslıhan Uzunkulaoğlu
Institution: Department of Physical Medicine and Rehabilitation, Ufuk University School of Medicine, Ankara, Turkey
Country: Turkey


Orcid: 0000-0003-0375-5233
Author: Saime Ay
Institution: Department of Physical Medicine and Rehabilitation, Ufuk University School of Medicine, Ankara, Turkey
Country: Turkey


Dates

Publication Date: July 4, 2019

EndNote %0 The European Research Journal Effectiveness of balance training with kinesthetic ability trainer (KAT 2000) in patients with peripheral neuropathic pain: a randomised controlled study %A Duygu Kerim , Aslıhan Uzunkulaoğlu , Saime Ay %T Effectiveness of balance training with kinesthetic ability trainer (KAT 2000) in patients with peripheral neuropathic pain: a randomised controlled study %D 2019 %J The European Research Journal %P -2149-3189 %V 5 %N 4 %R doi: 10.18621/eurj.408381 %U 10.18621/eurj.408381