Immediate effects of footwear with vibration applied to the swing phase of the gait cycle on dynamic balance in patients with diabetic peripheral neuropathy

Sensory and sub-sensory foot vibration have beneficial effects on the static and dynamic balance of patients with diabetic peripheral neuropathy (DPN). Previous foot vibration during walking was applied at sub-sensory threshold in both stance and swing phases of the gait cycle in DPN. This study aimed to investigate the effects of footwear with vibration above the sensory threshold applied to the swing phase of the gait cycle on the dynamic balance of DPN. Fifteen patients with DPN and 10 matched healthy control participants were enrolled in this study. Dynamic balance assessment was investigated by the sit to stand and turn tests while electromyography activity (root mean square, RMS) of the vastus lateralis (VL), tibialis anterior (TA), and peroneus longus (PL) muscles were recorded at baseline, after 10 min of wearing the vibratory sandal without vibration, and after 10 min of wearing the sandal with vibration. Repeated measure analysis of variance was conducted for data analysis. Wearing the vibratory sandal slightly increased the speed of weight transfer in both groups and COP sway in DPN (P > 0.05), and close to significant decrease of turn sway (P = 0.07) in both groups. There were significant differences of the PL RMS in turn test (P = 0.03) in DPN and peak RMS of the PL after 10 min of wearing the sandal with vibration in both groups (P < 0.05). The results of the present study demonstrated that PL activity was significantly influenced by the vibratory sandal as its tendon passing across the sole and in direct contact with the source of the vibration.

COMPARATIVE ANALYSIS OF KNEE MUSCLE DAMAGE OF DIFFERENT ATHLETES

ABSTRACT Introduction: The knee joint is the most complex weight-bearing joint in the human body. An athlete's knee joint is prone to injury in competitive sports; it is one of the most common injuries and, in some sports, severe meniscus and cruciate ligament injuries occur frequently as, for example, in handball and soccer, and can even end the career of an elite athlete. Objective: To explore the comparison of knee flexion and extension force injury in different athletes. Methods: The characteristics of the flexor and extensor muscle of the knee joint in handball, football and cycling were studied with the isokinetic technique. Results: The role of the knee joint in different types of sports played by athletes is obviously different, which leads to the different requirements of the flexor and extensor muscle in the knee joint. Conclusions: The key to improving the conditions of superior strength and preventing sports injury is to develop the features of specific strength reasonably. Level of evidence II; Therapeutic studies - investigation of treatment results.

Factors associated with relative muscle strength in patients with type 2 diabetes mellitus

OBJECTIVES

Some patients with type 2 diabetes mellitus (T2DM) experience decreased mobility associated with lower relative muscle strength (normalized with muscle mass). This study aimed to identify factors predicting relative muscle strength of patients with T2DM assessed at regular clinical visits.

METHODS

A total of 144 T2DM patients underwent fasting blood drawing (determining white blood cell count [WBC], diabetic kidney disease [DKD], and glycated hemoglobin [HbA1c]) and the assessment of body composition, diabetic peripheral neuropathy (DPN), activity level, and muscle strength (grip, knee extensor, and ankle plantar flexor strength). One-way ANOVA and multiple regression models were used to identify factors associated with the relative muscle strength.

RESULTS

Our data showed that age, diabetes duration, fat percentage, WBC, DPN, and DKD were negatively associated with the relative muscle strength. Specifically, a greater WBC was associated with lower relative muscle strength of both distal and proximal muscle groups of extremities after the adjustment of other associated factors. DPN was associated with lower relative strength of the distal muscle groups of extremities.

CONCLUSIONS

WBC may be used as a marker of inflammation, and greater count, even within the normal range, is negatively associated with the relative muscle strength in patients with T2DM.

Turkish version of the Michigan Neuropathy Screening Instrument in the assessment of diabetic peripheral neuropathy: a validity and reliability study

Background/aim

Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes mellitus (DM). The Michigan Neuropathy Screening Instrument (MNSI) is a simple, brief, and useful screening tool that was designed to assess DPN. The aim of this study was to develop a Turkish version of the MNSI and assess its reliability and validity.

Materials and methods

Eighty-three patients with DM who were divided into two groups according the results of nerve conduction studies (NCS) as having DPN or without DPN were enrolled in this cross-sectional study. The Toronto clinical scoring system, pain detect questionnaire, and NCS were assessed along with the MNSI.

Results

Each section of the MNSI was internally consistent (Cronbach's alpha > 0.70), and the scores of both sections were positively correlated with total MNSI score (r = 0.938; r = 0.908, respectively, p < 0.001). The test-retest reliability of the Turkish version of the MNSI was determined as 0.99 for the total score (intraclass correlation coefficient = 0.996). Using the agreement between MNSI scores and DPN diagnosis by NCS as a gold standard, receiver-operating characteristic (ROC) curve values for section A and section B were estimated as 0.973 and 1.00, respectively. When a cut-off value ≥ 3.0 in section A and a cut-off value ≥ 2.0 in section B were used, we obtained a sensitivity of 97.6% and 100%; a specificity of 63.4% and 97.6%; a positive predictive value of 72.7% and 97.6%; and a negative predictive value of 96.3% and 100%, respectively.

Conclusion

The Turkish version of MNSI is a reliable and valid tool for screening DPN in Turkish patients.