RESUMO
Introducción: El síndrome de movilidad articular limitada (SMAL) aparece exclusivamente en pacientes con diabetes, tanto tipo 1 como tipo 2. Se manifiesta como una limitación en la movilidad articular que inicialmente afecta a las falanges proximales de las manos, seguidas, por orden de frecuencia, por muñecas, codos, hombros, rodillas y esqueleto axial. El diagnóstico se puede realizar mediante pruebas sencillas, como «el test de la oración». El objetivo fue conocer la prevalencia de pacientes diabéticos con SMAL, evaluar la asociación entre el SMAL y el grado de control glucémico y el riesgo de caídas accidentales. Pacientes y métodos: Estudio observacional transversal en el Centro de Salud de San Fernando II, Madrid (periferia). La muestra fueron 184 pacientes con un diagnóstico de diabetes superior a 5 años entre noviembre-marzo de 2013. Se utilizó el test de la oración para evaluar si los pacientes presentaban SMAL. El riesgo de caídas fue determinado según el test Timed Up & Go. Resultados: Un total de 99 pacientes (53,8%) (IC 95% 46,6-61) presentaron un test de la oración positivo. No se obtuvo una relación estadísticamente significativa con la HbA1c, en cambio, sí que se vio una asociación entre el test Timed Up & Go y el SMAL (p < 0,001) (IC 95% 1,173-1,611). Los pacientes con SMAL presentaban un riesgo moderado de caídas frente a aquellos sin SMAL, que presentaban un riesgo bajo. Conclusiones: Existe una alta prevalencia de SMAL en nuestro medio. Presentamos el primer estudio en donde se relaciona el SMAL con el riesgo de caídas en los pacientes diabéticos (AU)
Introduction: Limited joint mobility syndrome (LJMS) appears exclusively in both type 1 and type 2 diabetic patients. It is characterized by a limited range of digital motion, with involvement of small joints of the hands. It initially affects the proximal interphalangeal joints, followed by wrists, elbows, shoulders, knees, and axial skeleton. The diagnosis can be made by the simple «prayer sign» test. The objective was to study the prevalence of diabetic patients with LJMS, and to evaluate the association between LJMS and metabolic control, and the risk of accidental falls. Patients and methods: A cross-sectional study was conducted in the San Fernando II Health Centre, Madrid (suburbs). The sample consisted of 184 patients with a diagnosis of diabetes of over 5 years from November to March, 2013. The prayer sign was used to define which patients had LJMS. Fall risk was determined using the Timed Up & Go test. Results: A total of 99 patients (53.8%) (95% CI 46.6 to 61) had a positive prayer sign. No statistically significant relationship was found with HbA1c, but there was an association with the Timed Up & Go test (P < .001) (95% CI 1.173 to 1.611). The patients with LJMS had a moderate risk of falls compared with those without LJMS, which was of low risk. Conclusions: The prevalence of LJMS is high. This is the first study that shows a relationship between LJMS and the risk of falls in diabetic patients (AU)
Assuntos
Humanos , Acidentes por Quedas/estatística & dados numéricos , Limitação da Mobilidade , Diabetes Mellitus/epidemiologia , Artropatias/epidemiologia , Estudos Transversais , Fatores de Risco , Índice Glicêmico , Hemoglobina A/análiseRESUMO
INTRODUCTION: Limited joint mobility syndrome (LJMS) appears exclusively in both type 1 and type 2 diabetic patients. It is characterized by a limited range of digital motion, with involvement of small joints of the hands. It initially affects the proximal interphalangeal joints, followed by wrists, elbows, shoulders, knees, and axial skeleton. The diagnosis can be made by the simple "prayer sign" test. The objective was to study the prevalence of diabetic patients with LJMS, and to evaluate the association between LJMS and metabolic control, and the risk of accidental falls. PATIENTS AND METHODS: A cross-sectional study was conducted in the San Fernando II Health Centre, Madrid (suburbs). The sample consisted of 184 patients with a diagnosis of diabetes of over 5 years from November to March, 2013. The prayer sign was used to define which patients had LJMS. Fall risk was determined using the Timed Up & Go test. RESULTS: A total of 99 patients (53.8%) (95% CI 46.6 to 61) had a positive prayer sign. No statistically significant relationship was found with HbA1c, but there was an association with the Timed Up & Go test (P<.001) (95% CI 1.173 to 1.611). The patients with LJMS had a moderate risk of falls compared with those without LJMS, which was of low risk. CONCLUSIONS: The prevalence of LJMS is high. This is the first study that shows a relationship between LJMS and the risk of falls in diabetic patients.
