title: Diabetic sensory neuropathy effect on ankle joint movement perception.
abstract: OBJECTIVE
  To determine if diabetic subjects with lower extremity cutaneous sensory neuropathy also have a loss of ankle joint movement perception. The strength of association between measurements of ankle joint movement perception and measures of cutaneous sensory function was also investigated.
  
  
  METHODS
  Diabetic subjects with and without sensory neuropathy and individuals without diabetes participated in this study.
  
  
  METHODS
  All subjects were community-living individuals.
  
  
  METHODS
  Fifty-one subjects, ages 40 to 68. Seventeen of the 34 subjects with diabetes had significant distal sensory neuropathy as determined by cutaneous perception of mechanical vibration. All individuals without diabetes were volunteers from the community. Most subjects with diabetes were recruited through direct referral from their physicians.
  
  
  METHODS
  Ankle joint movement perception threshold (JMPT) was assessed using a device designed for this study. Cutaneous sensory function under both halluces was measured for vibration perception using a vibrometer and for touch-pressure perception using Semmes-Weinstein monofilaments.
  
  
  METHODS
  Ankle JMPTs (degrees) were compared to measurements of cutaneous vibration perception (volts) and touch-pressure perception (monofilaments force ratings).
  
  
  RESULTS
  Diabetic subjects with cutaneous sensory neuropathy demonstrated a significant loss of ankle movement perception (p < .01). Correlation between JMPT and cutaneous sensory tests ranged from Spearman's rank r = .43 to .67.
  
  
  CONCLUSIONS
  Although individuals with cutaneous sensory loss secondary to diabetic neuropathy also demonstrated loss of movement perception at the ankle, the relatively low explained variance between the two types of assessment (18% to 45%) indicates that the severity of ankle joint movement perception deficits cannot be directly implied from cutaneous sensory tests.
authors.affiliation: Program in Physical Therapy, Marquette University, Milwaukee, WI 53201-1881, USA.
authors.forename: G G
authors.initials: GG
authors.lastname: Simoneau
authors.forename: J A
authors.initials: JA
authors.lastname: Derr
authors.forename: J S
authors.initials: JS
authors.lastname: Ulbrecht
authors.forename: M B
authors.initials: MB
authors.lastname: Becker
authors.forename: P R
authors.initials: PR
authors.lastname: Cavanagh
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007699:Kinesthesis; D008297:Male; D008875:Middle Aged; D009068:Movement; D012046:Rehabilitation / Q000295:instrumentation; D015203:Reproducibility of Results