RESUMO
The study aimed to investigate the control and coordination of grip force (normal component) and load force (tangential component) in three different manipulation tasks in individuals with diabetes with and with no diagnosis of diabetic peripheral neuropathy (DPN) and healthy controls. Twenty-four individuals with type 2 diabetes mellitus, 12 with no (nDPN) and 12 with DPN (wDPN), and 12 healthy controls performed three manipulation tasks (static holding, lifting and holding, and oscillation) with the dominant hand, using an instrumented handle. Relative safety margin (% of GF exerted above the minimum GF needed to hold the object) was measured in all tasks. Individuals with diabetes from the nDPN and wDPN groups set lower relative safety margin than controls only in the static holding task. No other group effect was revealed, except a lower coefficient of friction between skin and object surface in individuals with DPN. The coordination between grip and load force and grip force control was not affected by the diabetes during dynamic manipulation tasks (lifting and holding and oscillation). However, when individuals with diabetes without and with DPN performed a manipulation task in which the inflow of cutaneous information was small and stable (static holding), grip force control was affected by the disease. This finding indicates that individuals with type 2 diabetes mellitus not diagnosed with DPN, already show mild impairments in the nervous system that could affect grip force control and that could be one of the first signs of neuropathy caused by the diabetes.
Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Neuropatias Diabéticas/fisiopatologia , Força da Mão/fisiologia , Estresse Mecânico , Adulto , Idoso , Antropometria , Sistema Nervoso Central , Força Compressiva , Feminino , Fricção , Humanos , Masculino , Pessoa de Meia-Idade , Oscilometria , Reprodutibilidade dos Testes , Segurança , PeleRESUMO
BACKGROUND: Evidence suggests that exercise improves neutrophil function. The decreased functional longevity of neutrophils and their increased clearance from infectious sites contribute to the increased susceptibility to infection and severity of infection observed in patients with diabetes. OBJECTIVE: Herein, we investigated the effects of a dance program on neutrophil number, function, and death in type 2 diabetes mellitus (T2DM) patients and healthy volunteers. METHODS: Ten patients with T2DM and twelve healthy individuals participated in a moderate-intensity dance training program for 4 months. The plasma levels of leptin, free fatty acids (FFAs), tumour necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-1ß (IL-1ß), and interleukin-1 receptor antagonist (IL-1ra); neutrophil counts; extent of DNA fragmentation; cell membrane integrity; and production of TNF-α, interleukin-8 (IL-8), interleukin-6 (IL-6), and IL-1ß in neutrophils were measured before and after training. RESULTS: Training reduced plasma levels of TNF-α (1.9-fold in controls and 2.2-fold in patients with T2DM) and CRP (1.4-fold in controls and 3.4-fold in patients with T2DM). IL-1ra levels were higher in the control group (2.2-fold) after training. After training, neutrophil DNA fragmentation was decreased in patients with T2DM (90%), while the number of neutrophils increased (70% in controls and 1.1-fold in patients with T2DM). CONCLUSION: Dance training is a nonpharmacological strategy to reduce inflammation and improve neutrophil clearance in patients with T2DM.