Comparison of functional exercise capacity, muscle strenght,quality of life and physical activity levels in healthy individuals with Type 2 diabetes mellitus and without diabetic peripheral neuropathy

Objective: The aim of this study was to compare the functional exercise capacity, muscle strength, quality of life and physical activity levels of Type 2 DM patients with and without DPN and healthy individuals. Method: A total of 94 individuals participated in the study; 32 with Type 2 DM (Group 1), 32 Type 2 DM patients with DPN (Group 2), and 30 healthy volunteers (Control Group). Demographic characteristics, laboratory findings and EMG results of the participants were recorded from their files. Body composition was evaluated with the bioelectrical impedance analysis system Bodystat 1500 device. Neuropathy Symptom Score scale was used to evaluate neuropathy symptom severity. Peripheral muscle strength (knee extension, ankle plantar flexion and eversion, and hand grip strengths) was measured with a hand-held dynamometer and hand dynamometer. Functional exercise capacity was evaluated using the six-minute walking test (6 DYT) and the six-minute step test (6 DBT). 30 sec sit-to-stand test was used to evaluate general lower extremity muscle strength and function. Overall quality of life was assessed using Nottingham Health Profile (NHP) questionnaire, disease-specific quality of life Ferrans and Powers Quality of Life Index Diabetes Mellitus Version questionnaire, and physical activity levels using the International Physical Activity Scale - Short Form (IPAQ-Short Form). Results: Knee extension, ankle plantar flexion and eversion muscle strength, six-minute walking distance in Group 1 and Group 2 were significantly decreased compared to the control group (p< 0,05). There was no significant difference between the three groups in terms of hand grip strength and physical activity levels (p> 0.05). A significant difference was found between the three groups between the 6 DBT and 30 sec sit-to-stand test results (p <0.05). Group 2's 6 DBT, 30 seconds sit-to-stand test results and overall quality of life were significantly lower than Group 1 and control group (p <0.05). In the disease-specific quality of life, only the "health and functionality" sub-parameter of Group 2 was found to be significantly lower than Group 1 (p <0.05). Sitting time of Group 1 and Group 2 was significantly higher than the control group (p <0.05). Conclusion: It was found that functional exercise capacity, muscle strength and quality of life of Type 2 DM patients with and without DPN were negatively affected. It has been shown that the tests evaluating functional exercise capacity (6DCT) and lower extremity functional level (30 seconds sit and stand test) are simple and effective evaluation methods that can be used in clinics to distinguish cases with DPN from DM cases without neuropathy. It was concluded that the tests that can be applied in physiotherapy and rehabilitation programs of type 2 DM patients in clinics will be important in terms of both the management of the disease and the prevention and reduction of complications specific to diabetes. Key Words: Type 2 Diabetes Mellitus, Diabetic Peripheral Neuropathy, Functional Exercise Capacity