Evaluation of lower extremity muscle strength of patients with Type 2 Diabetes Mellitus by isokinetic tests and effects of lower extremity muscle strength on walking and daily life

Evaluation of lower extremity muscle strength of patients with Type 2 Diabetes Mellitus by isokinetic tests and effects of lower extremity muscle strength on walking and daily life Introduction Polyneuropathy (PNP) is a very common and well-known complication of Type 2 Diabetes Mellitus (DM). Both DM and PNP cause limitations in mobility levels of patients and decrease the level of independence in daily life activities. In the later stages of PNP, mobility losses that occur as a result of losses in muscle strength are well known. However, besides PNP, metabolic disorders in the muscle of diabetic patients, decreased capillary blood flow and peripheral arterial diseases may cause loss of muscle strength. In this study, it was aimed to measure the lower extremity muscle strength of patients with and without PNP with Type 2 DM by isokinetic methods and to compare the results with healthy controls. Method The study included 30 patients with PNP (Group 1) and without (Group2) diagnosed with Type 2 DM and 30 healthy volunteers (Group 3, Control group) matched by age and gender. The lower extremity hip and knee flexion and extension muscle strengths of all participants were measured with a dynamometer. To evaluate the physical performances, the Stair Climb Test (SCT) and Timed Up and Go Test (TUG), which are physical function tests, were used. Quality of Life was assessed by SF-36 (short form). Results There was no significant difference in muscle strength, physical function tests and SF-36 parameters between diabetic patients with and without PNP (p>0.05). It was found that in both Group 1 and Group 2 patients, the majority of isokinetic tests that included muscle strength parameters proportioned to body weight (except hip retention peak torque/body weight parameters at 60 and 180°/sec) compared to the Control Group (p<0.05). All parameters of SF-36 were statistically significantly lower in diabetic groups (Groups 1 and 2) compared to the Control Group (p<0.05). Similarly, both diabetic groups completed the TUG and SCT tests in a longer period of time than the control group and showed less mobility. The isokinetic test results correlated positively with the SF-36 sub-parameters and negatively with the TUG and SCT tests. Conclusion As a result of the current findings: We observed that Type 2 DM, independent of PNP, which can be added to illness, impairs the lower extremity muscle functions of patients and reduces the functionality of patients in daily life and decreases the quality of life. Keywords: Type 2 Diabetes Mellitus, Polyneuropathy, Muscle Strength Loss, Isokinetic Measurement