Ettinger Lucas Richard, Boucher Ami, Simonovich Elisabeth
Department of Exercise Science, Willamette University, Salem, OR 97302, United States.
World J Diabetes. 2018 Mar 15;9(3):59-65. doi: 10.4239/wjd.v9.i3.59.
To investigate proprioceptive discrepancies in the lower extremity in persons with type 2 diabetes mellitus (T2DM).
In this cross-sectional study, a total of 46 older persons were divided into a T2DM group ( = 23) and a control group who did not have T2DM ( = 23). Participants were given a brief warm up with stretching exercises. Diabetic neuropathy scores were collected prior to proprioceptive testing. For proprioceptive testing, participants performed leg extensions to randomized target positions of 15°, 30°, 45, 60° degrees of elevation in the sagittal plane, each target was repeated a total of four times. Subjects were guided to target positions in the absence of visual feedback auditory cues from a custom JPS application. When the participant entered the target position, they memorized the location of their limb in space and subsequently attempted to re-locate this position in space. Proprioceptive errors were measured from the target positioned, target remembered, target repositioned protocol.
Proprioceptive accuracy was lower in the diabetic group at all levels of target angle than the control group ( < 0.05). The diabetic group had 46% greater inaccuracy than the control group at all levels of target position. Diabetics also reported greater neuropathy scores than controls in the past 12 mo < 0.01.
Deficits in lower limb localization and greater diabetic neuropathy scores were identified in this study. Our findings may be associated with deafferentation as peripheral neuropathy is a common complication with the disease. These findings may help to explain the declining balance function in the older persons with T2DM which is also commonly reported.
探讨2型糖尿病(T2DM)患者下肢本体感觉差异。
在这项横断面研究中,共46名老年人被分为T2DM组(n = 23)和非T2DM对照组(n = 23)。参与者先进行简短的拉伸热身运动。在进行本体感觉测试前收集糖尿病神经病变评分。对于本体感觉测试,参与者在矢状面将腿部伸展到随机设定的15°、30°、45°、60°抬高目标位置,每个目标重复4次。在没有视觉反馈的情况下,通过定制的关节位置传感(JPS)应用程序的听觉提示引导受试者到达目标位置。当参与者进入目标位置时,他们记住肢体在空间中的位置,随后试图在空间中重新定位该位置。根据目标定位、目标记忆、目标重新定位方案测量本体感觉误差。
糖尿病组在所有目标角度水平的本体感觉准确性均低于对照组(P < 0.05)。在所有目标位置水平,糖尿病组的误差比对照组高46%。糖尿病患者在过去12个月的神经病变评分也高于对照组(P < 0.01)。
本研究发现糖尿病患者下肢定位能力不足且糖尿病神经病变评分更高。由于周围神经病变是该疾病的常见并发症,我们的研究结果可能与传入神经阻滞有关。这些发现可能有助于解释T2DM老年患者平衡功能下降的现象,这也是常见的报道。