Investigation of the relationships between joint position sense, plantar sensation, balance and dual task performance in individuals with TYPE 2 diabetes

Our study was planned to investigate the relationships between joint position sense (JPS), plantar sensation, balance and dual task performance (DTP) in individuals with type 2 diabetes. Individuals between 30-65 years were included in the study. Demographic and physical characteristics of individuals were recorded. JPS measurements were performed bilaterally with a goniometer on the ankle and bubble inclinometer on the knee joint. Semmes Weinstein Monofilaments were used for plantar sensation and Pro-Kin Tecnobody Isokinetic Balance System was used for balance. DTP was assessed by adding motor and cognitive secondary tasks to the Time-Up and Go Test (TUG) and Single Leg Balance Time (SLBT), and dual task costs (DTC) were calculated. In this study, the evaluation results of 46 volunteers diagnosed with type 2 diabetes were analyzed. As a result of the analyzes, there were weak correlations between the amount of deviation of the right ankle 10̊ dorsi flexion (DF) JPS and plantar sensations of 1, 2, 3, 6 and 7th regions of the right foot and between the amount of deviation of the right ankle 20̊ plantar flexion (PF) JPS and the righ foot 2. region plantar sensation (Rho=0.306, Rho=0.382, Rho=0.358, Rho=0.379, Rho=0.330, Rho=0.306; p<0.05). In addition it was detected that there were moderate correlations between the amount of deviation of the right ankle 10̊ DF JPS and 4th region plantar sensation of right foot, the amount of deviation of 20̊ PF JPS and plantar sensations of 4 and 6th regions (Rho=0.427, Rho=0.404, Rho=0.544; p<0.05). There was a weak correlation between amount of deviation of the left ankle 10̊ DF JPS and plantar sensations of 6 and 7th regions of left foot (Rho=0.369, Rho=0.308; p<0.05). There was a weak correlation between amount of deviation of the left knee 30̊ JPS and plantar sensation of left foot 5th region (Rho=0.320; p<0.05). There was a moderate correlation between amount of deviation of the left ankle 10̊ PF JPS and TUG-C (TUG-Cognitive Task) (Rho=0.464; p<0.05). There was a weak correlation between the amount of deviation of the right ankle 10̊ DF JPS and SLBT-S (SLBT-Single Task) (Rho=-0.306; p<0.05). There was a weak correlation between the amount of deviation of the left ankle 10̊ PF JPS and SLBT-S (Rho=-0.327; p<0.05). There was a moderate correlation between the amount of deviation of the left ankle 10̊ PF JPS and DTC TUG-C (Rho=0.406; p<0.05). In addition, a weak correlation was found between the amount of deviation of the left ankle 20̊ PF JPS and DTC SLBT-M (Rho=-0.305; p<0.05). It was found weak correlations between the amounts of deviation of the right knee 45̊ and 60̊ JPS and TUG-C (Rho=0.295, Rho=0.300; p<0.05). There was a weak correlation between the amount of deviation of the right knee 30̊ and 45̊ JPS and DTC TUG-C (Rho=0.347, Rho=0.397; p<0.05). There was also a weak correlation between the amount of deviation of the left knee 30̊ JPS and DTC TUG-M (Rho=0.319; p<0.05). There was a weak correlation between plantar sensation of the first region of the right foot and the ellipse value with eyes open (Rho=0.310; p=0.036). In addition, there was a correlation between plantar sensation of 2nd region and ellipse value with eyes open, perimeter values with eyes open and closed and plantar sensation of 4th region and eyes open perimeter values (Rho=0.312, Rho=0.335, Rho=0.303 Rho=0.340; p<0.05). There were moderate correlations between the plantar sensation of 5th region and eyes open and closed perimeter values (Rho=0.417, Rho=0.379; p<0.05). A weak correlation was found between the plantar sensation of 7th region and the stability limit values (Rho=-0.303; p<0.05). In the left foot, there was respectively moderate and weak relationships between plantar sensation of first region and ellipse values with open and closed eyes (Rho=0.469, Rho=0.380; p<0.05). While it was found that weak correlations between plantar sensation of 3rd region and perimeter values with eyes open and closed (Rho=0.381, Rho=0.337; p<0.05), there were respectively moderate and weak correlations between plantar sensation of 5th region and perimeter values with eyes open and closed (Rho=0.419, Rho=0.368; p<0.05). In addition, weak correlations were detected between plantar sensations of 4 and 7th regions and eyes open perimeter values (Rho=0.297, Rho=0.389; p<0.05). There were weak correlations between the plantar sensation of 3 and 4th regions and TUG-S (Rho=-0.298, Rho=-0.351; p<0.05). There was a weak correlation between the stability limit and TUG-C value (Rho =-0.328; p<0.05). As a result of our study, in line with the relationships between JPS, plantar sensation, balance and DTP in type 2 diabetic individuals, the relationships between diabetes-related changes in JPS and plantar sensation with each other and with the functional parameters such as balance therefore DTP should be considered clinically and other possible factors should be investigated.