Ferreira J.P.1, Sartor C.D.2, Sacco I.C.N.2, Leal Â.M.O.3, Sato T.O.1, Ribeiro I.L.1, Soares A.S.1, Cunha J.E.1, Salvini T.F.1
1Federal University of São Carlos, Laboratory of Skeletal Muscle Plasticity Department of Physical Therapy, São Carlos, SP, Brazil, 2Faculty of Medicine, University of São Paulo, São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, São Paulo, SP, Brazil, 3Federal University of Sao Carlos, Department of Medicine, São Carlos, SP, Brazil
Background: Skeletal muscle function was poorly described and understood in diabetics subjects associated to diabetic peripheral neuropathy.
Purpose: The propose of this study was to investigate the extensor and flexor torques of the knee and ankle during concentric, eccentric and isometric contractions in men with type 2 diabetes mellitus with and without diabetic peripheral neuropathy.
Methods: Three groups of adult men (n= 92) matched to age and anthropometric characteristics were analyzed: thirty three non-diabetic controls age: (48,94 ± 10,84); BMI: (27,21 ± 3,87), 31 type 2 diabetes mellitus age: (52,41 ± 8,48); body mass index (BMI): (28,25 ± 3,20) and 28 diabetic peripheral neuropathy age: (53,96 ± 6,57); BMI: (28,19 ± 4,01). The peak torques in the concentric, eccentric and isometric contractions were evaluated with an isokinetic dynamometer during knee and ankle flexion and extension. The peripheral neuropathy was defined according to a fuzzy model of signs and symptoms.
Results: Individuals with type 2 diabetes and diabetic peripheral neuropathy presented similar lower concentric and isometric knee and ankle torques that were lower from the controls. However, the eccentric torque was similar among groups, contractions and joints.
Conclusion(s): Regardless of the presence of peripheral neuropathy, differences in the skeletal muscle function were found, even in the early stages of type 2 diabetes mellitus. The muscle involvement does not follow the same pattern of sensorial losses, since there is no distal to proximal impairments. Both the knee and ankle were affected, but the knee concentric and isometric torques presented even larger effect sizes than the ankle. The eccentric function did not reveal differences between the healthy and the two diabetic groups, raising questions about the involvement of the passive muscle components.
Implications: Regardless of the presence of peripheral neuropathy, there are differences in skeletal muscle function in the early stages of type 2 diabetes. Knee and ankle torques were affected in diabetic subjects, but the knee concentric and isometric torques presented even larger effect sizes than the ankle.
Funding acknowledgements: Fundação de Amparo à Pesquisa do Estado de São Paulo; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Topic: Musculoskeletal: lower limb
Ethics approval: Research Ethics Committee of the Federal University of São Carlos (protocol number: 797125)
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