Affiliations: [a] Department of Physiotherapy and Rehabilitation,
Faculty of Health Sciences, Hacettepe University, Ankara, Turkey | [b] Department of Sports Medicine, Faculty of Medicine,
Hacettepe University, Ankara, Turkey | [c] Department of Physiotherapy and Rehabilitation,
Faculty of Health Sciences, Gazi University, Ankara, Turkey | [d] Department of Physiotherapy and Rehabilitation,
Faculty of Health Sciences, Baskent University, Ankara, Turkey | [e] Department of Endocrinology and Metabolism, Faculty of
Medicine, Gazi University, Ankara, Turkey | [f] Department of Orthopaedics and Traumology, Faculty of
Medicine, Hacettepe University, Ankara, Turkey
Note: [] Corresponding author: Hande Guney, Department of Physiotherapy
and Rehabilitation, Faculty of Health Sciences, Hacettepe University, 06100
Ankara, Turkey. Tel.: +90 305 25 25; Fax: +90 312 305 1220; E-mail:
hande.guney@hacettepe.edu.tr
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.
Keywords: Diabetes, joint position sense, muscle strength
