Equilíbrio e ativação da musculatura da perna pré e pós fadiga de membros inferiores em mulheres com diabetes tipo 2

Abstract

Background and Purpose: Falls in older adults are related to injuries and high costs to the health care system. Older adults who develop type 2 diabetes have increased chance of falling. Falling in these individuals relates to neuropathy, somatosensory, cognitive, visual and vestibular impairments, and functional decline. Already know that muscle strength and balance impairments can increase the risk for falls and muscle fatigue reduces the capacity to generate force. Therefore, the objective of the present study was to compare muscle activation patterns and balance measurements during one-leg stance balance test in diabetes and nom diabetes older women before and after completion of a fatiguing rise-to-toes task. Methods: In the present case-control study, 54 older women were divided into two groups: type 2 diabetes (n=28; 70±6 years old) and non-type 2 diabetes (n=26; 71±8 years old). A force platform was used to assess balance during 1-legged stance, and surface electromyography was used to assess the tibialis anterior (TA) and gastrocnemius medialis (GM) activation. Independent t-test was used to assess differences between groups. The significance was set at α=0.05. The Receiver Operating Characteristic (ROC) curve was used to determine the responsiveness and the accuracy of each variable individually for discriminate type 2 diabetic older women from non type 2 diabetic older women. Results and Discussion: The Type 2 Diabetes older woman group had higher RMS_ML, RMS_AP, and TA_MEAN values than Nom-Diabetes older woman group, for both, before and after the fatiguing task. No significant differences were observed intragroups before and after fatiguing task. RMS_ML_PRE, RMS_ML_POST, RMS_AP_PRES, RMS_AP_POST, TA_MEAN_PRE and TA_MEAN_PRE values could discriminate type 2 diabetic older women than non-diabetic older women. Conclusions: Diabetic older women showed worse one-leg stance balance than non-diabetic, with no influence of the fatiguing rise-to-toes task. Type 2 Diabetes leaded to an unbalanced activation of leg muscles with increased TA activation. Moreover, the study identified cutoff point to discriminate diabetic older women’s postural balance.