AN OBSERVATIONAL STUDY ON HAND FUNCTION AMONG GERIATRIC POPULATION WITH DIABETES MELLITUS

A. Paul¹, A. Alex¹, K. Indira K. S.², A. Thachil³

¹Medical Trust Institute of Medical Sciences, College of Physiotherapy, Kochi, Kerala, India, ²Sree Narayana Institute of Medical Sciences, Department of Respiratory Medicine, Ernakulam, Kerala, India, ³MTIMS, College of Physiotherapy, Kochi, Kerala, India

Background: Diabetes Mellitus is a chronic condition and serious challenge to global health. The adverse effects of hyperglycemia on musculoskeletal, nervous systems and connective tissues may impair hand skills, grip, pinch strength, and fine handling skills. The hand has a crucial function in daily activities and it can have a huge impact on daily life activities in patients with Diabetes Mellitus. There is a scarcity in literature on hand dysfunction among persons with Diabetes. Most of the literature worked on diabetic foot complications and its treatment strategies whereas diabetic hand remained as an ignored area.

Purpose: To evaluate the hand grip and pinch strength, fine and gross dexterity and hand function among geriatric population with diabetes mellitus in Kerala.

Methods: This observational case control study was conducted on one hundred and forty geriatric people, with age above sixty five years from both genders based on inclusion and exclusion criteria. This study was approved by the institutional ethics committee and informed consent was gathered from all participants. The subjects were recruited using purposive sampling method and were divided into two groups with seventy each. The group A consisted of geriatric people with diabetes mellitus for more than ten years of duration and group B consisted of age matched healthy controls. The subjects were recruited from community dwelling geriatric population and old age homes in eastern part of Kerala. Both groups were evaluated for hand grip strength using hand grip dynamometer, pinch strength using pinch gauge, fine hand dexterity with nine hole peg test, gross hand dexterity using box and block test and hand function with Cochin hand function scale Indian version respectively. The unpaired t test was used to compare the variables of diabetic group and healthy controls using the SPSS software.

Results: The mean and standard deviation of hand grip and pinch strength, fine and gross hand dexterity and hand function was analyzed. Unpaired ‘t’ test was implemented to compare the results of group A and group B. the level if significance was kept as p ≤ 0.05. The analysis revealed statistically significant decrease in hand grip strength (p=0.02), pinch strength (lateral pinch p=0.04, tip to tip pinch p=0.04 and pad to pad pinch p=0.03), hand fine dexterity (p=0.03) and gross dexterity (p=0.05).The scores of cochin hand function scale did not reveal significant difference between both groups (p=0.32).

Conclusions: The functional impairments of hand among persons with diabetes mellitus may adversely affect the daily activities on self-care in long run. There is an urgent need to include hand function screening during routine evaluation of persons with diabetes mellitus. Future studies on influence of long duration of diabetes mellitus on hand functional activities may be explored.

Implications: There is an urgent need to implement hand exercise programs to improve and / or prevent deterioration of hand function among persons with diabetes mellitus. Routine screening of hand function need to be implemented among persons with diabetes mellitus.

Funding acknowledgements: This study was not funded by any agencies.

Keywords:
Hand Function
Diabetic hand
Hand dexterity

Topics:
Older people
Health promotion & wellbeing/healthy ageing/physical activity
Musculoskeletal

Did this work require ethics approval? Yes

Institution: Medical Trust Hospital, Kochi, Kerala

Committee: Institutional Ethics Committee

Ethics number: MTH/MPT/ EC/ 2892/ 21