Multichannel Emg-based Estimation of Fiber Conduction Velocity during Isometric Contraction in Diabetic Patients with Different Severity Degrees of Neuropathy Classified by a Fuzzy Expert System

This study compares muscle fiber conduction velocities during isometric maximal voluntary contraction in different degrees of diabetic neuropathy classified by a fuzzy expert model. Sixty-seven diabetic patients of both sexes were classified by a fuzzy expert system in four groups according to the neuropathy degree: absent, mild, moderate and severe. Average muscle fiber conduction velocities of gastrocnemius medialis, tibialis anterior, vastus lateralis and biceps femoris were assessed using linear array surface electrodes and one-way ANOVA was used to compare groups. Muscle fiber conduction velocities were significantly increased in the moderate group for the gastrocnemius medialis and decreased in the same group for the vastus lateralis. In the severe group, there was again a significant decrease for the gastrocnemius medialis. These results indicate that different mechanisms predominate in distal and proximal muscles at different degrees of disease severity, where axonal loss and muscle fiber diameter compensatory increase could be responsible for increased muscle fiber conduction velocity distally and proximally reinnervation of previously deinnervated fibers could be responsible for the reduction in the conduction velocity observed.