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Physiotherapy Theory and Practice
An International Journal of Physical Therapy
Volume 39, 2023 - Issue 3
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Descriptive Report

Functional decline in people with diabetes: Bidirectional relationships between body function and activity–participation components in a two-wave longitudinal structural equation modeling

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Pages 598-606 | Received 07 Mar 2020, Accepted 19 Nov 2021, Published online: 20 Jan 2022
 

ABSTRACT

This study examined the impact of diabetes over time. The sample included 68 people with diabetes used a three‐year longitudinal design to test a model of functional decline. Indicators of the body function and activity and participation components of the International Classification of Functioning, Disability and Health (ICF) were derived from the Nordic Musculoskeletal Questionnaire, World Health Organization Quality of Life-Brief version (WHOQOL-BREF), and Participation Scale. On the basis of the ICF framework, it is hypothesized and found that there is an interaction between the body function and the activity and participation components, which, in turn, are predictors of future functional capability. The structural equation analyses confirmed that at both T1 and T2 pain measures are associated with physical, psychological, and social functioning; environmental factors mediate the relationship between these two constructs. Moreover, the activity and participation component at T1 predicted the body function component at T2. The main finding suggests that functional consequences of diabetes are complex and multifactorial. The significant functional decline in people with diabetes in just three years is worrying. The theoretical and practical implications of these findings are discussed.

Acknowledgments

Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG); Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

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