Relação entre alteração do índice tornozelo braquial, qualidade de vida e comprometimento dos domínios da funcionalidade em portadores de diabetes com e sem feridas

Abstract

Introduction: Diabetes Mellitus (DM) is caused by a deficiency in the production or regulatory action of insulin. Among the main complications are wounds in diabetic feet, characterized by the presence of wounds that are difficult to heal, subject to infections and may result in amputations. These outcomes are also associated with peripheral arterial disease (PAD), marked by impaired blood flow in the lower limbs, impairing balance and gait speed, predisposing to falls, and reducing quality of life and functionality. The ankle-brachial index (ABI) is a test used to screen for PAD. Objective: This study aimed to verify the relationship between changes in ABI, quality of life and impairment of functional domains in DM patients with and without diabetic foot wounds. Methodology: This is a cross-sectional and descriptive study with individuals diagnosed with DM 2 who may or may not have wounds on their diabetic feet. This study is an excerpt from an umbrella project, corresponding to the initial phase of the project. The collection period was carried out from October 2023 to March 2024, at the diabetes outpatient clinic of the Walter Cantídio University Hospital (HUWC) and at the Outpatient Clinic of the Center for Technological Innovation in Human Rehabilitation-INOVAFISIO, based in the Department of Physiotherapy (DEFISIO) at the Federal University of Ceará-UFC. The sample was non-probabilistic for convenience and divided into two groups: group 1 (diabetics without wounds) and group 2 (diabetics with wounds). ABI and neuropathy assessments were carried out and the 12-item Short Form Survey (SF-12) questionnaires, which assess quality of life, and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) were applied to assess functionality. Results: The total number of participants was eighty individuals. Of this population, 52.50% were male and 47.50% female, of which 37.97% were retired. The percentage of those married or living with a partner in the group without wounds was 69.56% and, in the group with wounds, 59.65%. The percentage of diabetics who did not practice physical activity in the group without wounds (56.52%) was higher when compared to the group with wounds, 82.46%, and this difference was significant. Conclusions: There was no correlation between ABI, quality of life and functionality. However, there was a significant correlation between functionality in the domains: mobility, life activities (domestic, school and work) and the physical component of quality of life. There are limitations to life activities resulting from reduced mobility, with repercussions on the physical component of the SF-12, especially in patients with diabetic foot wounds.