Abstract
To comprehend the sensorimotor control ability in diabetic hands, this study investigated the sensation, motor function and precision pinch performances derived from a pinch-holding-up activity (PHUA) test of the hands of diabetic patients and healthy subjects. The precision, sensitivity and specificity of the PHUA test in the measurements of diabetic patients were also analyzed. We hypothesized that the diabetic hands would have impacts on the sensorimotor functions of the hand performances under functionally quantitative measurements. One hundred and fifty-nine patients with clinically defined diabetes mellitus (DM) and 95 age- and gender-matched healthy controls were included. Semmes-Weinstein monofilament (SWM), static and moving two-point discrimination (S2PD and M2PD), maximal pinch strength and precision pinch performance tests were conducted to evaluate the sensation, motor and sensorimotor status of the recruited hands. The results showed that there were significant differences (all p<0.05) in SWM, S2PD, M2PD and maximum pinch strength between the DM and control groups. A higher force ratio in the DM patients than in the controls (p<0.001) revealed a poor ability of pinch force adjustment in the DM patients. The percentage of maximal pinch strength was also significantly different (p<0.001) between the DM and control groups. The sensitivity, specificity and area under the receiver operating characteristic curve were 0.85, 0.51, and 0.724, respectively, for the PHUA test. Statistically significant degradations in sensory and motor functions and sensorimotor control ability were observed in the hands of the diabetic patients. The PHUA test could be feasibly used as a clinical tool to determine the sensorimotor function of the hands of diabetic patients from a functional perspective.
Highlights
Diabetes mellitus (DM) is a chronic illness that affects multiple organs and systems
While Diabetic neuropathy (DN) includes a host of diabetic neuropathic syndromes, chronic sensorimotor polyneuropathy, characterized by the presence of symptoms of peripheral nerve dysfunction, is the main clinical form [5]
Subjects The participants in this prospective case-control study included clinically defined diabetic patients who were diagnosed based on the 1997 criteria of the American Diabetes Association [31], and controls matched by age, gender, and handedness
Summary
Diabetes mellitus (DM) is a chronic illness that affects multiple organs and systems. Various functional and pathological changes occur in type 2 diabetes patients as a consequence of glycemic derangement [1,2]. Diabetic neuropathy (DN), a related microvascular complication [3], has been reported to have negative impacts on the performance of daily living activities [4]. While DN includes a host of diabetic neuropathic syndromes, chronic sensorimotor polyneuropathy, characterized by the presence of symptoms of peripheral nerve dysfunction, is the main clinical form [5]. The clinical features of chronic sensorimotor polyneuropathy are progressive and often start in the feet. While numerous investigations on diabetes have analyzed the corresponding symptoms with regards to pain, tingling, paresthesia and sensory loss in the lower extremities [9], few have examined neuropathies in the hands, as these are reported less often by diabetic patients
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