İnsülin Kullanan ve Kullanmayan Tip Iı Diyabetik Hastalarda Ayak Bileği Kassal Motor Aktivite, Eklem Pozisyon Hissi ve Dengenin İncelenmesi

Abstract

This study is designed to investigate muscular motor activity, joint position sense and balance in Type 2 Diabetic patients using insulin and not using insulin and to compare them with the control group. This study is conducted with 32 insulin-using diabetics (group 1), 40 not not insulin using diabetics (group 2) and 15 healthy persons as control group (group 3). After recording demographic characteristics of all participants, foot temperature (infrared thermometer), waist circumference (tape measure), sense (Semmes Weistein Monofilament-SWM), static balance (standing on one leg), plantar pressure distrubition (Harris and Beath Footprinting Mat), medial longitudinal arc (MLA) height (Chippaux- Smirak İndex), ankle joint position sense (JPS evaluation mechanism), tibialis anterior muscular motor activity (superficial EMG), foot/ankle functionality level (Maryland Foot Score), physical activity levels (International Physical Activity Questionnaire) and neurophathy (Neuropathy Symptom Score) evaluations were done. The results were compared with groups, waist circumferences were larger in diabetic patients then the control group (p< 0.05). In SWM sense test there were no differences between group 1 and 2, and diabetic patients in each gruop have reduced sense ratio (p< 0.05). In static balance evaluation group 1 have worse results than group 2 and 3 (p< 0.05), but there is no significiant difference between group 2 and 3. In plantar pressure distrubition, right foot metatarsal head, right foot heel and left foot heel has no pressure distrubition difference and in Maryland Foot Score evaluation there is no difference between group 1 and 2, but in diabetic patients values were different from control group. In neuropathy symptom evaluation, there were differences in normal sense score between all groups (p<0.05, in moderate severity score there were no differences between group 1 and 2 but there is significiant difference in favor of group 3. There were no differences between groups in foot tempreature, MLA height, JPS, tibialis anterior motor activity and physical activity levels (p>0.05). Results of this study indicates that sense, balance, plantar pressure distrubition, foot/ foot ankle fonctioning and neuropathy tests can be valuable to catch early symptoms for physiotherapists