Comparison Of Hand Grip, Hand Mobility And Upper Extremity Impairments In Type 2 Diabetics, V/S Healthy Matched Individuals
Hand Function in Patients of Type 2 Diabetics
Keywords:
Handgrip strength, Joint mobility, Type2 diabetes mellitus, Upper extremity functionAbstract
Background and Objectives: ‘Diabetic hand’ includes complications related to joint mobility and muscle strength with functional impairment. The objective was to compare upper extremity impairments, hand grip, pinch strength and joint mobility in patients with Diabetes Mellitus type2(T2DM) with non-diabetic subjects. Methods: Comparative cross-sectional study was conducted using purposive sampling. Thirty participants with T2DM, duration >/=5 years, age group>/=50 years were included in group A and thirty age and gender matched healthy non-diabetic controls in group B. UEFS(upper extremity functional scale) was filled by the participants. Hand Grip Strength(HGS) and Key Pinch Strength were measured using Handheld Dynamometer and Pinch Gauge respectively. Joint mobility of hand was assessed using ‘Prayer sign’ and ‘Tabletop test’. Results: Mean±SD of HGS group A(diabetics)=18.86±5.55kg and group B(non-diabetics)=31.73±6.76kg, Pinch Strength of group A=4.93±1.74 kg and of group B=7.4±1.10kg respectively. Mean±SD of UEFS group A=55.03±8.18 and group B=72.66±4.65 respectively. Prayer sign and Tabletop sign were positive in 7/30(23%) in group A and 1/30(3.3%) in group B. Analysis was done using Mann Whitney test and showed statistically significant difference between diabetics and non-diabetics, U=60.50,p<0.001 for HGS and U=111.0,p<0.001 for Pinch Strength and U=25.50,p<0.001 for UEFS. Conclusion: Upper extremity impairments of grip strength, mobility and function were common in patients with T2DM. [Shah P Natl J Integr Res Med, 2019; 10(1):1--5]
References
2. Mathew AJ, Nair JB, Pillai SS. Rheumatic musculoskeletal manifestations in type 2 diabetes mellitus patients in South India. Int J Rheum Dis 2011; 14(1): 55–60.
3. Mota M, Panus C, Mota E. Hand abnormalities of the patients with diabetes mellitus. Rom J Intern Med 2000; 38–39: 89–95.
4. ParminderKaurSandhu Gill, Ravneet Sandhuu; Dimple, Anterpreet KaurArora .Hand grip strength in type 2 diabetics and non-diabetics; Pak J Physiol 2015;11(3)
5. Arkkila PET, Gautier JE. Musculoskeletal disorders in diabetes mellitus: an update. Best Pract Res Clin Rheumatol 2003;17(6):945–70.
6. De Carvalho e Silvo F. Diabetic hands: A study on strength and function. Diab Met Syn; Clin Res Rev(2014), http://dx.doi.org /10.1016/j.dsx.2014.04 RabiaCherqaoui,Sheldon McKenzie, Gail Nunlee-Bland. Diabetic Cheiroarthropathy: A Case Report and Review of the Literature; Case Rep Endocrinol. 2013; 2013: 257028
7. Knowles HB. Joint contractures, waxy skin, and control of diabetes. The New England Journal of Medicine. 1981;305(4):217–219.
8. Fitzcharles MA, Duby S, Waddell RW, Banks E, Karsh J. Limitation of joint mobility (cheiroarthropathy) in adult noninsulin-dependent diabetic patients. Annals of the Rheumatic Diseases.1984;43(2):251–254.
9. K.M. Shah; B.R. Clark; J.B. McGill; M.J. Mueller. Upper Extremity impairments, pain and disability in patients with diabetes mellitus. Physiotherapy 101 (2015) 147-154
10. Raje YR, Cracknell G, Davoren PM. Frequency of hand and shoulder symptoms in patients with type 1 diabetes. Diabet Med. 2015; 32(7): 968–71.
11. Mustafa KN, Khader YS, Bsoul AK, Ajlouni K. Musculoskeletal disorders of the hand in type 2 diabetes mellitus: prevalence and its associated factors. Int J Rheum Dis. 2016; 19(7): 730–5.
12. Koley S, Gandhi M, Singh AP. Association of hand grip strength with height, weight and BMI in boys and girls aged 6–25 years of Amritsar, Punjab, India. Internet Journal of Biological Anthropology 2007;2(1):4.
13. Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg Am 1984;9(2):222–6.
14. Bert M. Chesworth, Clayon B. Hamilton. Reliability and Validity of Two Versions of the Upper Extremity Functional Index; Physiother Can. 2014 Summer; 66(3): 243–253
15. VimalUpreti, VivekVasdev, PawanDhull, and S. K. Patnaik; Prayer sign in diabetes mellitus; Indian J EndocrinolMetab. 2013 Jul-Aug; 17(4): 769–770.
16. Infante JR, Rosenbloom AL, Silverstein JH, Garzarella L, Pollock BH. Changes in frequency and severity of limited joint mobility in children with type 1 diabetes mellitus between 1976– 78 and 1998. J Pediatr 2001;138:33–7.
17. ErcanCentinus, Mehmet AkifBuyukbese, Murat Uzel, HasanEkerbicer, AhmetKaraoguz. Hand Grip strength in patients with type 2 diabetes mellitus. Diabetes Research and Clinical Practice 70 (2005); 278-286
18. Savas S, Koroglu BK, Koyuncuoglu HR, Uzar E, Celik H, Tamer NM et al. The effects of the diabetes related soft tissue hand lesions and the reduced grip strength on functional disability of hand in type 2-diabetic patients. Diabetes Res ClinPract 2007; 77(1):77–83. 14
19. Pedro Marques- Vidal, Peter Vollenweider, Gerard Waeber, Francois R. Jornayuoz; Grip strength is not associated with incident type 2 diabetes mellitus in healthy individuals: The Golaus study; Diabetes research and clinical practice 132(2017); 144-148.
20. Lundbaek K. Stiff hands in long-term diabetes. Acta Medica Scandinavica. 1957;158(6):447–451.
21. Rosenbloom AL, Silverstein JH, Lezotte DC. Limited joint mobility in childhood diabetes mellitus indicates increased risk for microvascular disease. The New England Journal of Medicine. 1981;305(4):191–194.
22. Pal B, Anderson J, Dick WC, Griffiths ID. Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin-dependent diabetes mellitus. British Journal of Rheumatology.1986;25(2):147–151.
23. Casanova JE, Casanova JS, Young MJ. Hand function in patients with diabetes mellitus. South Med J. 1991; 84: 1111–13.
24. Lewko J, Kochanowicz J, Zarzycki W, Mariak Z, Górska M, Krajewska et al. Poor hand function in diabetics. Its causes and effects on the quality of life. Saudi Med J. 2012; 33(4): 429–35.
