Evaluation of Ankle Joint Position Sense in Patients with Type 2 Diabetes Mellitus with Peripheral Neuropathy by Isokinetic Dynamometer.

IF 0.5 4区 医学 Q4 ORTHOPEDICS Journal of the American Podiatric Medical Association Pub Date : 2024-07-01 DOI:10.7547/22-035
Özlem Kılıç, Elem İnal, Hüseyin Demirci, Gülümser Aydın
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Abstract

Background: Proprioceptive disorders may occur when thick fibers are affected in diabetic neuropathy. This can lead to impaired joint stabilization and increased risk of falls and fractures. We evaluated joint position sense (JPS) in diabetic patients to detect those at risk for neuropathy earlier.

Methods: Sixty diabetic patients and 30 healthy individuals aged 30 to 60 years were included in the study and divided into three groups: 30 diabetic patients with peripheral neuropathy, 30 diabetic patients without peripheral neuropathy, and 30 nondiabetic control patients. Presence of neuropathy was determined electrophysiologically. Passive ankle JPS was evaluated by an isokinetic system in all three groups. Both 10° and 30° plantarflexion and 10° dorsiflexion were determined as target angles. The mean absolute angular error (MAAE) values for three trials with each angle were assessed by Kruskal-Wallis and Mann-Whitney U tests.

Results: The MAAEs with all of the angles were significantly higher in diabetic patients with peripheral neuropathy compared with diabetic patients without peripheral neuropathy and the control group (P < .001 for all of the comparisons). The MAAEs with right ankle 10° plantarflexion (P = .004) and 10° dorsiflexion (P = .007) and left ankle 10° plantarflexion (P = .008) were significantly higher in diabetic patients without peripheral neuropathy than in the control group.

Conclusions: According to these results, ankle JPS may be deteriorated before determination of neuropathy electrophysiologically.Therefore, we believe that prophylactic programs in terms of the risk of falls and fractures by evaluating JPS need to be developed in the early stages of diabetes.

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用等速测力计评估伴有周围神经病变的 2 型糖尿病患者的踝关节位置感。
背景:当糖尿病神经病变中的粗纤维受到影响时,可能会出现肢体感觉障碍。这会导致关节稳定性受损,增加跌倒和骨折的风险。我们对糖尿病患者的关节位置感(JPS)进行了评估,以便及早发现有神经病变风险的患者:研究纳入了 60 名糖尿病患者和 30 名 30 至 60 岁的健康人,并将他们分为三组:30 名有周围神经病变的糖尿病患者、30 名无周围神经病变的糖尿病患者和 30 名非糖尿病对照组患者。是否存在神经病变通过电生理学方法确定。所有三组患者的被动踝关节JPS均通过等速系统进行评估。10°和30°跖屈和10°背屈均被确定为目标角度。通过 Kruskal-Wallis 和 Mann-Whitney U 检验评估了每个角度三次试验的平均绝对角度误差(MAAE)值:结果:与无周围神经病变的糖尿病患者和对照组相比,患有周围神经病变的糖尿病患者所有角度的平均绝对角度误差都明显增大(所有比较中的 P < .001)。无周围神经病变的糖尿病患者右踝10°跖屈(P = .004)和10°背屈(P = .007)以及左踝10°跖屈(P = .008)的MAAEs明显高于对照组:因此,我们认为需要在糖尿病的早期阶段就通过评估 JPS 来制定预防跌倒和骨折风险的方案。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.
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