Relationship between self-reported impairments and clinical examination of upper extremity in subjects with type 2 diabetes mellitus.

Abstract

Background: Upper Extremity Impairments (UEIs) in type 2 DM(Diabetes Mellitus) usually occur after other complications of DM have occurred and can lead to disability and severely impact the quality of life. This study aimed to identify the UEIs by self-reported questionnaire and clinical findings and to investigate whether self-reported impairments conform to clinical findings and whether any vital questions about UEIs can be identified to screen the UEIs quickly in type 2 DM comprehensive assessment.

Methods: 91 medically diagnosed type 2 DM subjects were enlisted at a tertiary care hospital per the inclusion and exclusion criteria to participate in the study. Participants were asked to fill out a self-reported questionnaire regarding UEIs, following which a clinical examination of the upper extremity was performed to identify the UEIs.

Results: 85% of the participants self-reported UEIs. Self-reported shoulder pain was reported by n = 34 (37.3%), stiffness by n = 21(23.1%), and hand weakness by n = 24 (26.4%). Clinical examination of shoulder and hand revealed impairments such as hands against the back in n = 30(33%), lift-off sign in 22(24.1%), decreased finger extension in 11(12.1%), and thenar strength in 9(9.9%). Self-reported shoulder pain and hand stiffness were associated with clinically examined decreased shoulder mobility and rotator cuff (RC) tests (p < 0.05). Grip strength, thenar strength, and Phalen's sign decreased significantly with self-reported hand weakness (p < 0.05).

Conclusion: Self-reported shoulder pain and stiffness, hand stiffness, and weakness should be used to identify patients with UEIs needing comprehensive assessment and treatment. Significantly self-reported hand impairments can also be an indication to screen shoulder pathologies.