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Analysis of the joint stiffness influence in the eccentric torque of type 2 Diabetes Mellitus with and without peripheral neuropathy

Grant number: 18/11530-4
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): April 01, 2019
Effective date (End): April 09, 2021
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal researcher:Tania de Fatima Salvini
Grantee:Julya Pegatin Moreno Perea
Home Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil


Type 2 diabetes mellitus (DM2) is a chronic disease with epidemic indexes, associated to the hyperglycemia that leads to diabetic peripheral neuropathy (DPN) and non-enzymatic glycation of the collagen, and it might increase the stiffness of some structures, such as tendons and joint capsule. Studies suggest an increase of stiffness and the passive torque associated to the eccentric torque maintenance. However, are need studies analyzing this relationship.Objective: To analyze the passive and eccentric peak torque and its respective joint position in DM2 individuals with and without DPN, in relation to a non-diabetic control group.Hypothesis: Individuals with DM2, with and without DPN, will to present increased stiffness and passive torque than non-diabetic control group and the eccentric peak torque will be maintained and the joint position of the peak torque will be altered in DM2 individuals with and without DPN in relation to the control group. Methods: Passive and eccentric torques will be assessed using the isokinetic dynamometer (Biodex, System) by different joint motion speeds (5 ° / s, 30 ° / s and 60°/ s). To ensure the muscle silence during the passive torque, the electromyographic (EMG) signal will be collected using a surface electromyograph (Trigno, Delsys) and compared to the EMG resting signal. The DPN will be analyzed by the Michigan protocol for neuropathy screening and classified by a Fuzzy logic system. Glycemic control and the presence and absence of DM2 will be verified by the glycated hemoglobin test.Statistical analysis: All data will be submitted to the Kolmogorov-Smirnov and Levene tests to verify the normality and homogeneity in the distribution. Considering the normal distribution, the one-way analysis of variance (ANOVA) with post hoc Tukey will be applied to compare the groups in relation to clinical and demographic characteristics, eccentric peak torques, passive stiffness and the position of the eccentric torque position. The adopted level of significance is 5%. If the data do not present a normal distribution, the Kruskal-Wallis test and Mann Whitney test will be applied. The level of significance will be adjusted according to the number of comparisons.

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