産業医学および健康問題

抽象的な

Postural Balance Control of the Leprosy Patient with Plantar Sensibility Impairment

Thania Loiola Cordeiro, Marco Andrey Cipriani Frade, Ana Regina SB Barros and Norma Toraboschi Foss

Leprosy is a granulomatous disease that affects the peripheral nervous system, leading to loss of thermal, tactile and pain sensibility. Changes in plantar sensibility and proprioception caused by leprosy might affect postural balance control. The Body Center of Pressure (COP) constitutes the neuromuscular response to changes or accelerations of the body’s Center of Gravity and can be affected by orthopedic, neurological or rheumatic injuries. Fifteen multibacillary (MB) and 6 paucibacilary (PB) leprosy subjects were randomly selected, as well as 11 subjects without leprosy for the control group (GC). The MB and PB had their plantar sensibility checked by the Semmens- Weinstein test; all groups had their COP evaluated (stabilometry) using a baropodometer, during standing position with eyes opened and barefooted. The balance variations were measured by the displacement of the COP, as in COP ML (medial-lateral direction) and COP AP (anterior-posterior direction) for right and left feet and total body projection. The stabilometric analysis regarding COP AP revealed no statistically significant difference between groups MB, PB and GC, despite the presence of impaired sensibility in all leprosy patients. The same occurred with the COP ML. The comparison between right and left feet of MB, PB and GC did not show statistically significant differences, although the MB group present the highest variation between the COP projection over right and left feet There were found no consistent evidence suggesting in this study that patients with abnormal plantar sensibility might show disparities when compared to the GC for postural balance control. This is probably due to compensatory adjustments by the vision or ankle joint proprioception. Therefore, it was showed that the reduction on plantar sensibility alone might not be decisive to affect the postural body balance control on leprosy patients, and further investigation is needed.