Assessment of the lower extremity muscle strength in diabetic peripheral neuropathy patients measured by handheld dynamometer and its association with falling

To evaluate lower extremity muscle strength with a handheld dynamometer (HHD) in diabetic peripheral neuropathy (DPN) patients and to assess the possible association between muscle strength and falling that is a major public health problem.

 In this cross-sectional study, 15 patients with DPN,evaluated based on the Michigan neuropathy screening instrument (MNSI), and 10 healthy control (HC) were enrolled. Fall efficacy scale-International (FES-I) was completed to assess fear of falling (FOF). Muscle strength of the peroneus longus (PL), TA, gastrosoleus (GS), Hamstring (Ham), VL, quadriceps femoris (QF), gluteus maximus (GM), and hip abductors (HA) of the dominant (right) lower extremity was measured by HHD.

There was a moderate and negative correlation between FES-I and GS time to peak (r=-0.0607, P=0.016), and strong correlation between FES-I and MNSI (r=0.709, B=1.829,P=0.003). All the time to peak force results were higher in DPN in comparison to HC and became significant in TA, QF, and GM (P<0.05). The augmented force of the GM was significantly lower in DPN (P=0.021).

GS rate of force development had a negative correlation with fear of falling.FES-I and MNSI had strong correlation. Time to reach to the peak force was lower in DPN in comparison to HC and became significant in TA, QF, and GM, with strong effect sizes.