The effect of the physiotherapy program developed for the upper extremity in diabetic individuals on manual dexterity, proprioception and functionality

The aim of this study was to examine the effect of the physiotherapy program designed for upper extremity problems seen in diabetic individuals on dexterity, wrist proprioception and upper extremity functionality. The study was a randomized controlled trial. 56 type 2 diabetic patients (n=28 protocol, n=28 control group) and 19 healthy individuals were included in the study. Assessments were conducted at the beginning and end of the 12-week treatment program. Pain assessment was repeated at week 6. A physiotherapy program specifically developed for diabetic individuals was applied to the protocol group, and aerobic and strengthening exercises were applied to the control group. Hand dexterity with the 9-Hole Peg Test (9HPT), wrist joint position sense (JPS) with the goniometer, light touch sensation with the Semmes-Weinstein Monofilament Test, static and dynamic two-point discrimination with the discriminator, grip strength with the Jamar Dynamometer and pinchmeter, viscoelastic properties of thenar and hypothenar muscles with MyotonPRO, upper extremity functionality with Arm, Shoulder and Hand Problems Quick Questionnaire (Q-DASH) and Michigan Hand Outcome Questionnaire (MHQ), depression and anxiety level with Beck Depression Questionnaire and Beck Anxiety Questionnaire, Quality of life was evaluated with Short Form -36, and pain was evaluated with Visual Analogue Scale, Numerical Pain Scale, McGill Pain Questionnaire Short Form and Neuropathic Pain Questionnaire Short Form. 9HPT results were better for the right and left hands in the healthy group than the protocol (p<0.001) and control group (p<0.001). After treatment, an improvement was observed in the right and left hand scores of the protocol (p<0.001) and control group (p<0.001) in the 9HPT results. Right wrist flexion was better in the protocol group than in the control group after treatment for JPS (p=0.027). After treatment, an improvement was observed in Q-DASH and MHQ parameters in the protocol and control groups (p<0.05). It was concluded that the developed physiotherapy protocol was effective in improving hand dexterity, JPS and upper extremity functionality and could be used as a rehabilitation program in individuals with diabetes.