Evaluation de la mobilite active des doigts par la cotation de la distance pulpo-palmaire exprimee en travers de doigts

L'evaluation de la mobilite des doigts est realisee classiquement par des methodes exigeant l'utilisation des instruments comme goniometre; latte graduee et autres. La disponibilite de ces instruments dans les structures medicales non specialisees et la competence des medecins praticiens generalistes a les utiliser correctement ne sont pas evidentes.Le but de la presente etude est de proposer une methode qui utilise les seuls doigts du patient comme outil de mesure; sans aucune intervention instrumentale.Quatre cents sujets de la population de Mbujimayi en R.D. Congo (196 de sexe masculin et 204 de sexe feminin) ont ete examines dans cette etude qui a consiste a mesurer la largeur des doigts et les angles des articulations des doigts a differents degres de flexion.Une echelle simple et pratique est proposee a l'issue de l'etude pour coter les differents degres de flexion des doigts

Relationship between duration of diagnosis and neuromusculoskeletal complications of middle-aged type 2 diabetes patients

Abstract. BACKGROUND: Patients with Type 2 Diabetes (T2D) often present with complications involving the neuromusculoskeletal system which creep in as the condition advances in years. Hence there is a need to further understand how the duration of diagnosis of diabetes (DD) relates to the neuromusculoskeletal complications in order to design timely preventive programmes. OBJECTIVE: To investigate the relationship between the duration of diabetes and neuromusculoskeletal complications in type 2 diabetes. METHODS: This was a cross-sectional survey involving 139 consenting T2D patients and 139 age and sex-matched nondiabetic individuals. The participants were assessed for the DD and selected neuromusculoskeletal complications including muscle weakness, ranges of motion (ROM), pain and foot ulceration. RESULTS: The mean DD was 7.82 ± 2.41 years. There were significant differences (p < 0.01) between the clinical variables of both groups. In the diabetic participants, significant inverse relationships (P<0.05) were obtained between the DDD and each of muscle strength {elbow flexors (r = -0.57), knee extensors (r = -0.63), handgrip (r = ­0.82)}; ROM {wrist extension (r = -0.64) and ankle planterflexion (r = -0.63)}. Significant and direct relationships were obtained between the DDD and each of pain (r = 0.62) and ulcerative grading (r = 0.81). CONCLUSIONS: Type 2 Diabetes patients have poorer neuromusculoskeletal variables and longer duration of diabetes is associated with reduced muscle strength, diminished ROM, gradual ulceration of skin of the feet and higher level of foot pain. Immediate therapeutic exercises against these complications soon after diagnosis of diabetes may help to decelerate their progression