Institute of Physical Activity and Sports Sciences and Interdisciplinary Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil.
Institute of Physical Activity and Sports Sciences and Interdisciplinary Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil.
Hum Mov Sci. 2021 Jun;77:102793. doi: 10.1016/j.humov.2021.102793. Epub 2021 Apr 9.
The study aimed to investigate the control and coordination of grip force (normal component) and load force (tangential component) in three different manipulation tasks in individuals with diabetes with and with no diagnosis of diabetic peripheral neuropathy (DPN) and healthy controls. Twenty-four individuals with type 2 diabetes mellitus, 12 with no (nDPN) and 12 with DPN (wDPN), and 12 healthy controls performed three manipulation tasks (static holding, lifting and holding, and oscillation) with the dominant hand, using an instrumented handle. Relative safety margin (% of GF exerted above the minimum GF needed to hold the object) was measured in all tasks. Individuals with diabetes from the nDPN and wDPN groups set lower relative safety margin than controls only in the static holding task. No other group effect was revealed, except a lower coefficient of friction between skin and object surface in individuals with DPN. The coordination between grip and load force and grip force control was not affected by the diabetes during dynamic manipulation tasks (lifting and holding and oscillation). However, when individuals with diabetes without and with DPN performed a manipulation task in which the inflow of cutaneous information was small and stable (static holding), grip force control was affected by the disease. This finding indicates that individuals with type 2 diabetes mellitus not diagnosed with DPN, already show mild impairments in the nervous system that could affect grip force control and that could be one of the first signs of neuropathy caused by the diabetes.
本研究旨在探讨糖尿病患者在无和有糖尿病周围神经病变（DPN）诊断的情况下，三种不同操作任务中对握力（法向分量）和负载力（切向分量）的控制和协调。24 名 2 型糖尿病患者，12 名无（nDPN）和 12 名有（wDPN），以及 12 名健康对照者，使用仪器手柄，用惯用手完成三种操作任务（静态握持、提起并保持、振荡）。在所有任务中都测量了相对安全裕度（所施加的握力相对于握持物体所需的最小握力的百分比）。nDPN 和 wDPN 组的糖尿病患者在静态握持任务中的相对安全裕度低于对照组。除了 DPN 患者的皮肤和物体表面之间的摩擦系数较低外，没有发现其他组间效应。在动态操作任务（提起并保持和振荡）中，糖尿病并未影响握力和负载力之间的协调以及握力控制。然而，当无和有 DPN 的糖尿病患者执行一个传入皮肤信息较少且稳定的操作任务（静态握持）时，握力控制受到疾病的影响。这一发现表明，未被诊断为 DPN 的 2 型糖尿病患者已经表现出神经系统的轻度损伤，这可能会影响握力控制，并且可能是由糖尿病引起的神经病变的早期迹象之一。
