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Neuromuscular Dysfunction in Diabetes: Role of Nerve Impairment and Training Status

SCOTTO SACCHETTI, MASSIMO1; BALDUCCI, STEFANO2,3; BAZZUCCHI, ILENIA1; CARLUCCI, FLAMINIA1; DI PALUMBO, ALESSANDRO SCOTTO1; HAXHI, JONIDA1; CONTI, FRANCESCO2; DI BIASE, NICOLINA4; CALANDRIELLO, EUGENIO5; PUGLIESE, GIUSEPPE2

Medicine & Science in Sports & Exercise: January 2013 - Volume 45 - Issue 1 - p 52–59
doi: 10.1249/MSS.0b013e318269f9bb
Basic Sciences

Purpose: The purpose of this study was to investigate the effect of diabetes, motor nerve impairment, and training status on neuromuscular function by concurrent assessment of the torque–velocity relationship and muscle fiber conduction velocity (MFCV).

Methods: Four groups were studied (n = 12 each): sedentary patients with diabetes in the first (lower) and fourth (higher) quartile of motor nerve conduction velocity (D1 and D4, respectively), trained diabetic (TD) patients, and nondiabetic sedentary control (C) subjects. Maximal isometric and isokinetic contractions were assessed over a wide range of angular velocities for the elbow flexors and knee extensors to evaluate the torque–velocity relationship. Simultaneously, MFCV was estimated from surface electromyography of the vastus lateralis and biceps brachii.

Results: Isometric strength was similar among groups. The dynamic strength of elbow flexors was reduced in patients with diabetes at the higher contraction speeds. The strength of knee extensors was lower in sedentary patients with diabetes at all velocities considered, with significantly lower values in D1 than that in D4 at 60°, 90°, and 120°·s−1, whereas it was similar between TD and C subjects, especially at low contraction velocities. At the vastus lateralis, but not the biceps brachii, MFCV was lower in D1 and D4 as compared with TD and C subjects, showing similar values.

Conclusions: Muscle weakness in diabetes affects also the upper limb, although to a lower extent than the lower limb, is only partly related to motor nerve impairment, and is dependent on contraction velocity. Exercise training might counteract diabetes-induced alterations in muscle fiber contractile properties and MFCV.

1Department of Human Movement and Sport Sciences, “Foro Italico” University, Rome, ITALY; 2Department of Clinical and Molecular Medicine, “La Sapienza” University, and Diabetes Unit, Sant’ Andrea Hospital, Rome, ITALY; 3Metabolic Fitness Association, Monterotondo, Rome, ITALY; 4Diabetes Unit, Fatebenefratelli San Pietro Hospital, Rome, ITALY; and 5Neurology and Neuro-Pathophysiology Unit, Regina Apostolorum Hospital, Albano, Rome, ITALY

Address for correspondence: Massimo Sacchetti, Ph.D., Department of Human Movement and Sports Sciences, “Foro Italico” University, Piazza Lauro De Bosis, 15-00135 Rome, Italy; E-mail: massimo.sacchetti@uniroma4.it.

Submitted for publication May 2012.

Accepted for publication July 2012.

©2013The American College of Sports Medicine