Sacco Isabel de Camargo Neves, João Silvia Maria Amado, Alignani Denise, Ota Daniela Kinoshita, Sartor Cristina Dallemole, Silveira Leda Tomiko, Gomes Aline Arcanjo, Cronfli Regeane, Bernik Márcia
Hospital Universitário, Centro de Docência e Pesquisa, Universidade de São Paulo, São Paulo, Brazil.
Sao Paulo Med J. 2005 Sep 1;123(5):229-33. doi: 10.1590/s1516-31802005000500006. Epub 2005 Dec 8.
Physiotherapy can contribute towards recovering or preventing physical and sensory alterations in diabetic neuropathy patients. Our objective was to create and apply a protocol for functional assessment of diabetic neuropathy patients' lower limbs, to guide future physiotherapy.
Clinical study at the University Hospital and teaching/research center of Universidade de São Paulo.
An intentional sample of diabetic neuropathy patients was utilized. The protocol was divided into: (1) preliminary investigation with identification of relevant clinical diabetes and neuropathy characteristics; (2) thermal, tactile and proprioceptive sensitivity tests on the feet; (3) evaluations of muscle function, range of motion, lower limb function, foot anthropometry.
The patients' mean age was 57 years, and they had had the diagnosis for 13 years on average. Distal numbness and tingling/prickling were present in 62% and 67%, respectively. There were tactile sensitivity alterations above the heel in 50%, with thermal sensitivity in 40% to 60%. The worst muscle function test responses were at the triceps surae and foot intrinsic muscles. Longitudinal plantar arches were lowered in 50%. Decreased thermal and tactile sensitivity of the heels was found. There was a general reduction in range of motion.
The results provided detailed characterization of the patients. This protocol may be easily applied in healthcare services, since it requires little equipment, at low cost, and it is well understood by patients.
物理治疗有助于糖尿病神经病变患者恢复或预防身体及感觉功能改变。我们的目的是制定并应用一项针对糖尿病神经病变患者下肢功能评估的方案，以指导未来的物理治疗。
在圣保罗大学医院及教学/研究中心开展的临床研究。
采用糖尿病神经病变患者的意向性样本。该方案分为：（1）初步调查，确定相关的糖尿病和神经病变临床特征；（2）足部的热觉、触觉和本体感觉敏感性测试；（3）肌肉功能、关节活动范围、下肢功能、足部人体测量学评估。
患者的平均年龄为57岁，平均确诊时间为13年。分别有62%和67%的患者存在远端麻木以及刺痛/针扎样感觉。50%的患者足跟上方存在触觉敏感性改变，40%至60%的患者存在热觉敏感性改变。最差的肌肉功能测试反应出现在小腿三头肌和足部固有肌。50%的患者纵弓降低。发现足跟的热觉和触觉敏感性下降。关节活动范围普遍减小。
研究结果提供了患者的详细特征描述。该方案所需设备少、成本低且患者易于理解，可轻松应用于医疗服务中。
