Musculoskeletal disorders in diabetes mellitus patients in a Physical Medicine and Rehabilitation department.

OBJECTIVE: The objective of this study was to assess the musculoskeletal disorders (MSD) of diabetes mellitus (DM) patients in a Physical Medicine and Rehabilitation (PMR) department.

MATERIAL/PATIENTS AND METHODS: We carried out a retrospective study (January-December 2013) in which we enrolled 193 patients with DM. General (epidemic and clinical) characteristics were measured. Statistical analysis was performed using the statistical software SPSS 16.

RESULTS: The participants' median age was 58 years (20-86), 98 men (50.8%) and 95 women (49.2%). The median DM duration was 10 years and the median follow up period was 8 months. DM was managed by diet in 3.6% of cases, by oral antidiabetic drugs in 48.7% of cases and by insulin therapy in 47.7% of cases. A quarter of patients consulted for shoulder pain, adhesive capsulitis was the most common diagnosis (14.8%). Knee osteoarthritis and low back pain were reported respectively in 22.2% and 12.9% of DM patients. Carpal tunnel syndrome was found in 50% of cases. More than half of the studied population (76.2%) was followed for diabetic foot and transtibiale amputation. DM patients were managed by rehabilitation in 35.1% of cases. Equipment for lower limb amputee was prescribed in all cases but only 14.3% received their orthesis. Functional improvement was obtained in 73.4% of cases.

DISCUSSION-CONCLUSION: Our results suggest that MSD were prevalent in diabetic patients seen in PMR department. The most common problems were diabetic foot and lower limb amputation which are frequent complications of this metabolic disorder. Carpal tunnel syndrome and shoulder pain (adhesive capsulitis) are frequent also. An appropriate and personalized rehabilitation program should be prescribed for each patient. The main objectives of care are to guarantee a good functional outcome and to improve the patients' quality of life.