Knee proprioception, muscle strength, and stability in Type 2 Diabetes Mellitus- A cross-sectional study

Abstract

BackgroundThe burgeoning prevalence of Type 2 Diabetes Mellitus (T2DM) has been linked to a spectrum of health complications, including those affecting the musculoskeletal system. Knee proprioception, muscle strength, and stability are essential for maintaining functional mobility and preventing falls, yet their relationship with T2DM is not fully elucidated. ObjectivesThis study aimed to compare knee proprioception, muscle strength, and limits of stability (LOS) between individuals with T2DM and asymptomatic controls and to examine the moderating role of physical activity on these relationships. MethodsIn a cross-sectional design, 192 participants (96 with T2DM and 96 asymptomatic) underwent assessments for knee proprioception using a digital inclinometer, muscle strength via a handheld dynamometer, and LOS through dynamic posturography, graded as a percentage of maximum lean without losing balance. ResultsOur analysis revealed that individuals with T2DM demonstrated reduced knee muscle strength, with mean differences of 12.90 Nm (right) and 18.80 Nm (left) in 25° of flexion, and 25.78 Nm (right) and 26.36 Nm (left) in 40° of flexion, compared to asymptomatic controls. Proprioception errors were greater in the T2DM group (p < 0.001), with significant deficits noted in both knee 25° of flexion and 40° of flexion. Stability limits were also compromised, with the T2DM group displaying a decreased ability to maintain balance across all tested directions (p < 0.001). Physical activity emerged as a positive moderator, with higher activity levels correlating with improved muscle strength and stability. ConclusionT2DM significantly impairs musculoskeletal function, highlighting the need for integrated management strategies. The study underscores the importance of physical activity in mitigating T2DM-related musculoskeletal deterioration, suggesting that therapeutic interventions should include a focus on enhancing muscle strength and stability to improve the quality of life in this population.