Abstract
BACKGROUND: Aim of this study is to evaluate ankle joint position sense (JPS) in the diabetic patients without peripheral neuropathy (PN). The hypothesis was that diabetes would lead to decreased JPS even if there was no PN.
METHODS: Thirty-seven patients with diabetes and 22 healthy controls were included in the study. PN was detected with the use of Semmes-Weinstein Monofilament test (SWMT), vibration testing by the timed method (128 Hz diapason) and two point discrimination sensation test. JPS was measured as the subjects' ability to actively reproduce target ankle dorsiflexion (DF) and plantarflexion (PF). The concentric isokinetic peak torques of the ankle DF and PF were recorded using the Biodex® System 3 Dynamometer.
RESULTS: JPS was significantly lower in diabetic patients than control subjects. PF isokinetic muscle torque at 30°/s, 60°/s and 180°/s was significantly lower in diabetic patients than control subjects but DF muscle torque did not differ between the groups.
CONCLUSIONS: Diabetic patients displayed decreased ankle joint position sense and muscle torque even though they had no peripheral neuropathy. Treatment strategies aiming at improving proprioception and muscle strength in early stage could be beneficial to prevent the patients from diabetes complications.