Shoulder assessment in individuals with Diabetes Mellitus: cross-sectional and longitudinal study

• Grant number: 21/01771-7
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• Start date: March 01, 2022
• End date: March 01, 2026
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Paula Rezende Camargo
• Grantee: Julia Kortstee Ferreira
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
• Associated scholarship(s): 23/11825-2 - Consensus recommendations for pain phenotyping in people with Diabetes Mellitus: an international & interdisciplinary study using the nominal group technique, BE.EP.DD

Abstract

Some studies have already shown an association between Diabetes Mellitus (DM) and the presence of musculoskeletal disorders and pain in the shoulder joint. However, studies that have assessed which factors may be related to shoulder pain development in these individuals are still scarce. Diabetic Peripheral Neuropathy (DPN) is a common complication of DM that in the lower limbs contributes to the emergence of several disorders. The manifestation of DPN in the upper limbs and how it may be related to the development of shoulder pain and dysfunction in these individuals is still unclear in the literature. This study will be divided into two. Study 1 will be a cross-sectional study with the aim of comparing shoulder pain and function between individuals with DM with DPN, without DPN, and controls. Study 1 will also assess the signs and symptoms of DPN in the upper limbs of individuals with DM with and without signs of DPN in the lower limbs. Study 2 will be a longitudinal study with the aim of verifying the incidence of shoulder pain over 1 year in individuals with DM and controls without DM, and to analyze which factors can be predictors for the development of shoulder pain in these individuals. One hundred and eleven individuals will participate in study 1 and will be divided into three groups: Group 1 - 37 individuals with DM and DPN; Group 2 - 37 individuals with DM without DPN; Group 3 - 37 controls without DM and without neuropathy. Two hundred and ninety-four individuals without shoulder pain will participate in study 2: 147 individuals with DM and 147 controls without DM. The level of physical activity, the presence of DPN in the lower limbs, the signs and symptoms of DPN in the upper limbs, the pain and function of the shoulder, the range of motion and muscle function of the shoulder, and the functional performance of the upper limb will be evaluated in the participants for the two studies. The normality of the data will be assessed using the Kolmogorov-Smirnov test. For study 1, a One Way ANOVA will be applied according to the data to be analyzed for comparison of the groups, and also the Pearson or Spearman correlation tests will be used to analyze the association between the DPN in the lower limbs and the symptoms of the DPN in the upper limbs. For study 2, the pain-free probability will be estimated by the Kaplan-Meier actuarial analysis, and the relative rate and 95% confidence interval (95% CI) of having pain for both groups will be estimated and compared using models of Cox proportional hazards regression. For all analyzes, the level of significance will be set at 5%. (AU)