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Master's Dissertation
DOI
10.11606/D.5.2012.tde-19122012-101055
Document
Author
Full name
Ricky Watari
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2012
Supervisor
Committee
Sacco, Isabel de Camargo Neves (President)
França Junior, Marcondes Cavalcante
Vilibor, Renata Hydee Hasue
Title in Portuguese
Análise da progressão das alterações eletromiográficas da marcha de diabéticos neuropatas classificados atráves de um modelo linguístico fuzzy
Keywords in Portuguese
Diabetes mellitus
Eletromiografia
Lógica fuzzy
Marcha
Neuropatias diabéticas
Abstract in Portuguese
O uso de um sistema fuzzy baseado em regras pode permitir uma melhor distinção entre diferentes graus da polineuropatia sensoriomotora distal diabética, possibilitando um esclarecimento de quais são as alterações de atividade muscular e em que estágio da doença elas ocorrem nos diabéticos. As alterações eletromiográficas durante a marcha de diabéticos descritas até hoje não são muito consistentes entre os autores e são sutis, e uma das possíveis causas é a dificuldade em definir grupos experimentais homogêneos com definições claras da gravidade da doença de cada sujeito. Ao classificar pacientes diabéticos em graus de neuropatia de ausente a grave com a lógica fuzzy, ficou elucidado que mudanças na atividade muscular se iniciam mesmo antes da instalação da neuropatia, com atrasos no vasto lateral em 31% na recepção de carga e antecipação do tibial anterior no apoio terminal da marcha em 16%. A neuropatia diabética piora o quadro, exacerbando a antecipação do tibial anterior nas fases mais graves, chegando a uma diferença de 33%, e tornando o pico de ativação do mesmo músculo precoce no início da fase de apoio. As alterações musculares parecem ser causadas por mudanças estruturais e fisiológicas do tecido muscular em si por causa dos sub-produtos gerados pela hiperglicemia em função do mal controle do diabetes mellitus e este quadro é agravado pela instalação dos acometimentos neurológicos com o desenvolvimento da polineuropatia diabética
Title in English
Analysis of the progression of alterations in gait electromyography in subjects with diabetic neuropathy classified by a fuzzy linguistic model
Keywords in English
Diabetes mellitus
Diabetic neuropathies
Electromyography
Fuzzy logic
Gait
Abstract in English
The use of Fuzzy expert model could be an interesting approach to enable a better distinction among different stages of diabetic sensorimotor polyneuropathy, and differences in muscle activity and in the time when these changes start occurring could be elucidated with this classification. EMG alterations during gait, supposedly caused by this disease, are subtle and still not consistent among authors, possibly due to difficulties in defining homogeneous experimental groups with clear definition of the disease stage of each subject. By classifying diabetic patients from absent to severe neuropathy with fuzzy logic, it clarified that muscle activity changes begin even before diabetic neuropathy is established , with delays of up to 31% in vastus lateralis peak activity at early stance and anticipation of 16% in tibialis anterior onset during terminal stance. The presence of diabetic neuropathy aggravates the changes in tibialis anterior, with 33% earlier onset time, and delayed peak activity at heel strike. Muscular alterations seem to be caused by structural and physiological changes in muscle tissue itself, caused by accumulation of advanced glycation end-products due to poor diabetes control, and these alterations become worse with the onset of neurological impairments when diabetic neuropathy is established
 
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RickyWatari.pdf (1.57 Mbytes)
Publishing Date
2012-12-19
 
WARNING: The material described below relates to works resulting from this thesis or dissertation. The contents of these works are the author's responsibility.
  • PICON, A.P., et al. Classification of the severity of diabetic peripheral neuropathy: a new approach taking into account the uncertainties [doi:10.6061/clinics/2012(02)10]. Clinics (USP. Impresso) [online], 2012, vol. 67, p. 151-156.
  • HAMAMOTO, A.N., et al. Plantar pressure during gait in diabetic neuropathy: Effect of severity degree classified by a Fuzzy expert model. In XIII Expert Scientific Meeting - Load Distribution, Aalborg, Dinamarca, 2012. Proceedings of the XIII Expert Scientific Meeting.Aalborg : Aalborg University, 2012. Abstract.
  • WATARI, R., et al. Análise da pressão plantar na marcha de diabéticos com diferentes graus de neuropatia periférica classificados por um sistema fuzzy. In XIV Congresso Brasileiro de Biomecânica, Ribeirão Preto, 2011. Anais do XIV Congresso Brasileiro de Biomecânica.Ribeirão Preto : Sociedade Brasileira de Biomecânica, 2011. Resumo.
  • WATARI, R., et al. Gait EMG of diabetic neuropathic patients: effect of disease severity classified by a fuzzy expert model. In XIX Congress of the International Society of Electrophysiology and Kinesiology, Brisbane, 2012. Proceedings of the XIX Congress of the International Society of Electrophysiology and Kinesiology.Brisbane, Australia : International Society of Electrophysiology and Kinesiology, 2012. Abstract.
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