Impact of diabetic polyneuropathy on ventilatory function and respiratory muscle endurance / Marwa Mostafa Abdelmoneem Afifi ; Supervised Moshera H. Darwish , Sandra A. Mohamed , Heba Ahmed Metwally

Thesis (M.Sc.) - Cairo University - Faculty of Physical Therapy - Department of Physical Therapy for Neuromuscular and Neurosurgery

Background: Diabetic polyneuropathy is one of the most common complications associated with diabetes mellitus. Respiratory neuromuscular function may be affected by polyneuropathy in type II diabetes. Objective: To determine the impact of diabetic polyneuropathy on ventilatory function and respiratory muscle endurance and to determine the effect of different degrees of severity of diabetic polyneuropathy on ventilatory function and respiratory muscle endurance. Patients and Methods: Ninety type II diabetic patients and thirty matched normal subjects from both genders represented the sample of the study. Their age ranged from 40 to 60 years. They were assigned into two groups; control group (G1) to provide the normal values of pulmonary function, and study group (G2). The study group was subdivided into three matched equal subgroups; (G2a) included diabetic patients without neuropathy; (G2b) included diabetic patients with clinically diagnosed neuropathy and (G2c) included diabetic patients with confirmed neuropathy with nerve conduction studies (NCS). The diabetic polyneuropathy was clinically assessed and rated by Toronto Clinical Neuropathy Scoring System (TCNS) and confirmed by NCS. Autonomic symptoms were assessed in all diabetic patients by Survey of Autonomic Symptoms (SAS). Ventilatory function (FVC, FEV1, and FEV1/FVC) and respiratory muscle strength (PEF) and endurance (MVV) were assessed by Jaeger Vyntus IOS spirometer. Results: revealed a significant decrease in all measured variables in both (G2b) and (G2c) when comparing with (G1) and group (G2a) except FEV1/ FVC ratio which is similar in four groups. Non-significant difference in FVC, FEV1, MVV and PEF between (G2b) and (G2c) or between (G2a) and (G1) was observed. A significant negative correlation was observed between the scores of TCNS and all measures of respiratory functions. A significant negative correlation between the age and MVV was detected

Issued also as CD