Impact of Diabetic Neuropathy on Ankle Dorsiflexion in Older Adults

Abstract

Background: Diabetes mellitus is increasing among the population. If early diagnosis and treatment can be done, complications can be reduced. Although there are studies evaluating the impact of diabetes on joint motion, there are limited studies examining the ankle range of motion and its correlation with duration or severity of diabetic neuropathy symptoms. This study aims to examine the impact of diabetic neuropathy on angle of ankle dorsiflexion and it’s correlation with duration or severity of diabetic neuropathy symptoms Methods: Descriptive study in Government medical college, Thoothukudi. 72 patients attending the outpatient department of Medicine and Neuromedicine of a tertiary care hospital, ranging from 40 to 75 years were included in the study out of which 36 were diabetic with symptoms of diabetic neuropathy and 36 were non-diabetic. Ankle range of motion was measured using goniometer. Severity of neuropathy assessed using Toronto Clinical Neuropathy score and duration of diabetic neuropathy symptoms recorded. Results: Mean Age (Diabetic group) 59.28±8.06 Vs 56.08±10.16 (Non-Diabetic group). Proportion of patients with decreased angle of dorsiflexion among the patients with diabetic neuropathy (77.8%) was significantly higher than non-diabetic patients (47.2%) (Z=4.52;p<0.0001). Chi-square (2χ) test showed that there was significantassociation between severity of diabetic neuropathy and angle of dorsiflexion (in degree) of the patients with diabetic neuropathy (p<0.0001). Angle of dorsiflexion decreased significantly with severity of diabetic neuropathy. Pearson correlation co-efficient showed that there was significant negative correlation between duration of diabetic neuropathy and angle of dorsiflexion (r=-0.61;p<0.001). Thus with the increase in duration of diabetic neuropathy angle of dorsiflexion decreased significantly.Conclusions: It was found that the angle of ankle dorsiflexion was lower in diabetic patients as compared to non-diabetic patients It was also concluded that the duration of diabetic neuropathy and severity of sensory symptoms have an inverse relationship with ankle range of motion.