The Isokinetic and Electromyographic Assessment of Knee Muscles Strength in the Short- and Long-Term Type 2 Diabetes

Low thigh muscle strength in relation to myosteatosis in patients with type 2 diabetes mellitus

This study aimed to investigate the association of thigh muscle fat infiltration by quantitative MRI with muscle strength in patients with type 2 diabetes mellitus (T2DM). Seventy T2DM patients and sixty control subjects (71 males; age: 52 ± 8 years) underwent 3.0T MRI and isokinetic muscle strength measurements to obtain the skeletal muscle index (SMI), intermuscular adipose tissue (IMAT) proton density fat fraction (PDFF), intramuscular fat (IMF) PDFF, peak torque (PT) and total work (TW) of knee extensors and flexors. The differences of measurements between T2DM patients and asymptomatic volunteers were compared. Multivariate regression analysis was used to determine significant predictors of thigh extension and flexion strength. The SMI, IMAT and IMF PDFF of thigh muscles in T2DM patients were higher than that in the control group (p < 0.001), while PT and TW were lower than those in the control subjects (p < 0.05). Both IMF and IMAT PDFF were negatively correlated with PT, TW in participants with T2DM (extensors: r = - 0.72, - 0.70, p < 0.001; r = - 0.62, - 0.56, p < 0.05. flexors: r = - 0.37, - 0.43, p < 0.05; r = - 0.39, - 0.46, p < 0.05). Moderate and strong correlations between HOMA-IR and muscle strength measurements, muscle PDFFs were observed in extensors and flexors. IMF PDFF and age were the statistically significant predictor of PT and TW of extensors of thigh in multivariate regression analysis. Therefore, the thigh muscle PDFF increased was associated with muscle strength decreased in T2DM patients beyond SMI. Age are also important factors influencing thigh muscle PDFF and strength in T2DM patients.

Morphological and functional changes in skeletal muscle in type 2 diabetes mellitus: A systematic review and meta-analysis

INTRODUCTION

Changes in the skeletal muscle are common in patients with type 2 diabetes mellitus (T2DM). These changes impair your motor skills.

OBJECTIVE

This systematic review aimed to investigate changes in skeletal muscle in patients with T2DM.

METHODS

The search was carried out in the PubMed, Scopus, and Web of Science databases until December 1, 2021. Observational studies that evaluated musculoskeletal changes in people with T2DM were included. The review was based on PRISMA recommendations. The primary parameters analyzed were muscle strength, muscle mass, muscle power, and muscle endurance.

RESULTS

Forty-eight studies were included, with a total of 26,042 participants. The results revealed that T2DM is associated with a reduction in handgrip [-2.64 (CI 95% = -3.33 to -1.95, Z = -7.50, p < .0001], and knee extension muscle strength [-0.56 (CI 95% = -0.76 to -0.36, Z = -5.64, p < .0001)], a higher percentage of type II fibers [11.74 (CI 95% = 6.24 to 17.25, Z = 4.18, p < .0001)], and a lower percentage of type I fibers [-15.69 (CI 95% = -18.22 to -13.16, Z = -12.16, p < .0001], in addition to a greater thickness of the calcaneus tendon (p < .0001).

CONCLUSION

Individuals with T2DM present skeletal muscle impairments, mainly reduced muscle strength, mass, and endurance; increase in the thickness of the calcaneus tendon, and alteration in the proportion of type I and II fibers, even in the initial stage of the disease.

Type 2 Diabetes Mellitus Patients Manifest Greater Muscle Fatigability Than Healthy Individuals During Dynamic Fatigue Protocol

OBJECTIVE

The present study aimed to investigate the electromyographic (EMG) indices of muscle fatigue along with biochemical marker of fatigue-that is, blood lactate-during a dynamic fatigue protocol in individuals with type 2 diabetes mellitus (T2DM) vs a healthy control group. Secondarily, it aimed to examine the association between EMG indices of muscle fatigue and blood lactate in these patients.

METHODS

Thirty-four participants took part in the study: 19 individuals with T2DM (age, 53.5 ± 6.85 years) and 15 age-matched healthy controls (age, 50.2 ± 3.55 years). Participants performed a dynamic fatigue protocol consisting of 5 sets of 10 repetitions each at an intensity of the 10-repetition maximum. Surface EMG of the vastus medialis and vastus lateralis muscles was recorded during the dynamic fatigue protocol, and EMG indices such as median frequency (MF), slope of MF (MF_slope), Dimitrov muscle fatigue spectral index, and root-mean-square were evaluated for each contraction across all the 5 sets. Blood lactate concentrations were also assessed 3 times during the fatigue protocol.

RESULTS

Findings revealed that EMG muscle fatigue indices such as MF, MF_slope, and Dimitrov muscle fatigue spectral index were significantly altered in individuals with T2DM vs healthy individuals across the sets and repetitions for both the vastus medialis (P < .001) and vastus lateralis muscles (P < .001). There was a significantly greater rise in blood lactate in individuals with T2DM than in healthy individuals (P < .001), which was not found to be associated with changes in EMG indices of muscle fatigue.

CONCLUSION

Findings suggest the existence of significantly greater fatigue in the knee extensor muscles of individuals with T2DM than healthy individuals.

Force Variability in the Short- and Long-Term Type 2 Diabetes Mellitus

Background:

Force variability is related to many kinesiological and neuromuscular properties of the body. This study was conducted to evaluate the effect of type 2 diabetes mellitus (T2DM) and sex on the several fractal and entropy indices of force changing during the repetitive isokinetic exercise of knee flexion-extension.

Methods:

Fifty individuals were allowed to participate in the study, and they consist of 18 patients with short-term T2DM, 12 patients with long-term T2DM, and 20 gender/body mass index/ankle imposed to brachial pressure index and physical activity index-matched healthy control (HC) individuals. Torque of knee flexion-extension was recorded for each cycle of 40 isokinetic repetitions at a velocity of 150°/s. The slope across the peak of torques and nonlinear fractal and entropy features in the time series was calculated. Two-way univariate analysis of variance was used to analyze the effect of the groups and gender on the variables.

Results:

The slope of flexor peak torques was significantly less in the long-term T2DM than the other groups. However, the fractal features such as SD1 and 2 of Poincare plot and fractal dimension katz were significantly decreased in the T2DM groups than the HC and in the women than men. Alpha detrended fluctuation analysis and empirical hurts exponent increased in women of short-term T2DM than men.

Conclusion:

The force variability decreased in the T2DM as compared to HC and in women as compared to men. However, the randomness of force was significantly increased in women of short-term T2DM.