Correlação entre instrumentos de avaliação da funcionalidade e sinais neuropáticos em indivíduos com Diabetes Mellitus: um estudo transversal

Abstract

BACKGROUND: Diabetes Mellitus (DM) is a chronic condition that represents a serious public health problem, affecting one in ten people worldwide. Its complications can be divided into microvascular and macrovascular impairments, with peripheral neuropathy being one of the most prevalent among this population, causing significant damage to functioning and quality of life. OBJECTIVE: To analyze the relationship between neuropathic signs, functional components, and domains of functioning in individuals with diabetic neuropathy. METHODS: This is a cross- sectional study with a quantitative approach involving individuals diagnosed with Diabetes Mellitus at the Rehabilitation Department of the Outpatient Clinics of Walter Cantídio University Hospital, affiliated with the Federal University of Ceará, during the period from July 2024 to April 2025. A clinical assessment of Diabetes Mellitus was conducted (application of the Neuropathic Symptoms Scale – NSS, Visual Analog Scale for Pain – VAS, and Neuropathy Impairment Score – NIS), functional tests – 6-Minute Walk Test (6MWT), One-Repetition Maximum Test (1RM), Short Physical Performance Battery (SPPB), quality of life questionnaire (SF-12), diabetes coping attitude questionnaire (ATT-19), and disability assessment through WHODAS 2.0. The Shapiro- Wilk test was used to analyze the normality distribution, Spearman's test to verify the correlation between evaluated items, and multiple linear regression analysis, considering a p-value <0.05 for statistical significance. RESULTS: A total of 27 individuals with diabetic neuropathy were evaluated, with a mean age of 59.7 ± 9.8 years, and 81.5% were female. Strong correlations were found between total SPPB performance and 6MWT (rho = 0.761; p < 0.001), gait speed and 6MWT (rho = 0.726; p < 0.001), WHODAS 2.0 mobility and NIS (rho = 0.802; p < 0.001). Moderate correlations were observed between 6MWT and 1RM (rho = 0.576; p = 0.003), total SPPB score and 1RM (rho = 0.539; p = 0.007), SF-12 physical component and NIS (rho = -0.569; p = 0.002), and VAS (rho = -0.508; p = 0.008), SPPB balance with NIS (rho = -0.563; p = 0.002); sit-to-stand with 1RM (rho = 0.622; p = 0.001) and with 6MWT (rho = 0.589; p = 0.002). In the linear regression analysis, associations were observed between 6MWT performance and other functional components, mobility with neuropathic signs, and SF-12 physical component with VAS. CONCLUSION: This study observed strong correlations between aspects of functional performance (mainly involving 6MWT and 1RM), the physical component of quality of life, and signs and symptoms of diabetic neuropathy. These data suggest that neuropathy contributes to the degree of disability related to the physical component and functioning.