A Randomized Control Study of Effectiveness of Aerobic Exercise Training and Balance Training on Balance in Patients with Diabetic Peripheral Neuropathy
Article Sidebar
Main Article Content
Abstract
Background: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes that can lead to significant balance issues, increasing the risk of falls and associated morbidity. Exercise is known to mitigate these complications, yet the comparative effectiveness of different exercise modalities remains underexplored.
Objective: The study aimed to evaluate the effectiveness of aerobic exercise training compared to balance training and traditional balance exercises in improving balance among patients with DPN.
Methods: A randomized controlled trial was conducted at Mayo Hospital, Lahore, with 60 patients diagnosed with DPN, divided equally into three groups: Group A (aerobic exercise), Group B (balance training), and Group C (traditional balance exercises). Each group received interventions three times weekly for four weeks. Balance was assessed using the Berg Balance Scale (BBS) pre- and post-intervention. Data were analyzed using SPSS version 25, with paired t-tests and one-way ANOVA to evaluate treatment effects.
Results: Post-treatment BBS scores showed significant improvement across all groups (p < 0.001). Group A exhibited the greatest improvement, with mean scores increasing from 47.20 to 52.65. Group B's scores increased from 43.95 to 48.25, while Group C showed the least improvement, from 43.95 to 46.80.
Conclusion: Aerobic exercise significantly enhances balance in DPN patients compared to balance training and traditional exercises, highlighting its potential as a primary intervention strategy.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Hicks CW, Selvin E. Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Current Diabetes Reports. 2019;19(10):86.
Knauf MT, Koltyn KF. Exercise-Induced Modulation of Pain in Adults with and Without Painful Diabetic Neuropathy. The Journal of Pain. 2014;15(6):656-63.
Kluding PM, Pasnoor M, Singh R, Jernigan S, Farmer K, Rucker J, et al. The Effect of Exercise on Neuropathic Symptoms, Nerve Function, and Cutaneous Innervation in People with Diabetic Peripheral Neuropathy. Journal of Diabetes Complications. 2012;26(5):424-9.
Colberg SR, Sigal RJ. Prescribing Exercise for Individuals with Type 2 Diabetes: Recommendations and Precautions. The Physician and Sportsmedicine. 2011;39(2):13-26.
Mueller MJ, Tuttle LJ, Lemaster JW, Strube MJ, McGill JB, Hastings MK, et al. Weight-Bearing Versus Nonweight-Bearing Exercise for Persons with Diabetes and Peripheral Neuropathy: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation. 2013;94(5):829-38.
Smith AG, Russell J, Feldman EL, Goldstein J, Peltier A, Smith S, et al. Lifestyle Intervention for Pre-Diabetic Neuropathy. Diabetes Care. 2006;29(6):1294-9.
Richardson JK. Factors Associated with Falls in Older Patients with Diffuse Polyneuropathy. Journal of the American Geriatrics Society. 2002;50(11):1767-73.
Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and Type 2 Diabetes: The American College of Sports Medicine and the American Diabetes Association Joint Position Statement. Diabetes Care. 2010;33(12).
Herbert RD, de Noronha M, Kamper SJ. Stretching to Prevent or Reduce Muscle Soreness After Exercise. The Cochrane Database of Systematic Reviews. 2011;7.
Fritschi C, Quinn L, Hacker ED, Penckofer SM, Wang E, Foreman M, et al. Fatigue in Women with Type 2 Diabetes. The Diabetes Educator. 2012;38(5):662-72.
Reusch JE, Bridenstine M, Regensteiner JG. Type 2 Diabetes Mellitus and Exercise Impairment. Reviews in Endocrine & Metabolic Disorders. 2013;14(1):77-86.
Gohel MG, Chacko AN. Serum GGT Activity and hsCRP Level in Patients with Type 2 Diabetes Mellitus with Good and Poor Glycemic Control: An Evidence Linking Oxidative Stress, Inflammation and Glycemic Control. Journal of Diabetes and Metabolic Disorders. 2013;12(1):56.
Mueller MJ, Minor SD, Sahrmann SA, Schaaf JA, Strube MJ. Differences in the Gait Characteristics of Patients with Diabetes and Peripheral Neuropathy Compared with Age-Matched Controls. Physical Therapy. 1994;74(4):299-308.
Timar B, Timar R, Gaiță L, Oancea C, Levai C, Lungeanu D. The Impact of Diabetic Neuropathy on Balance and on the Risk of Falls in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. PLoS One. 2016;11(4).
Boulton AJM. Management of Diabetic Peripheral Neuropathy. Clinical Diabetes. 2005;23(1):9-15.
Jahantigh Akbari N, Hosseinifar M, Naimi SS, Mikaili S, Rahbar S. The Efficacy of Physiotherapy Interventions in Mitigating the Symptoms and Complications of Diabetic Peripheral Neuropathy: A Systematic Review. Journal of Diabetes & Metabolic Disorders. 2020.
Parasoglou P, Rao S, Slade JM. Declining Skeletal Muscle Function in Diabetic Peripheral Neuropathy. Clinical Therapeutics. 2017;39(6):1085-103.
Hussain G, Rizvi SAA, Singhal S, Zubair M, Ahmad J. Cross-Sectional Study to Evaluate the Effect of Duration of Type 2 Diabetes Mellitus on the Nerve Conduction Velocity in Diabetic Peripheral Neuropathy. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2014;8(1):48-52.
Allen MD, Doherty TJ, Rice CL, Kimpinski K. Physiology in Medicine: Neuromuscular Consequences of Diabetic Neuropathy. Journal of Applied Physiology. 2016;121(1):1-6.
Allen MD, Major B, Kimpinski K, Doherty TJ, Rice CL. Skeletal Muscle Morphology and Contractile Function in Relation to Muscle Denervation in Diabetic Neuropathy. Journal of Applied Physiology. 2014;116(5):545-52.
Brown SJ, Handsaker JC, Bowling FL, Boulton AJ, Reeves ND. Diabetic Peripheral Neuropathy Compromises Balance During Daily Activities. Diabetes Care. 2015;38(6):1116-22.
Hilton TN, Tuttle LJ, Bohnert KL, Mueller MJ, Sinacore DR. Excessive Adipose Tissue Infiltration in Skeletal Muscle in Individuals with Obesity, Diabetes Mellitus, and Peripheral Neuropathy: Association with Performance and Function. Physical Therapy. 2008;88(11):1336-44.
Horlings CG, van Engelen BG, Allum JH, Bloem BR. A Weak Balance: The Contribution of Muscle Weakness to Postural Instability and Falls. Nature Clinical Practice Neurology. 2008;4(9):504-15.
Horn S, Quasthoff S, Grafe P, Bostock H, Renner R, Schrank B. Abnormal Axonal Inward Rectification in Diabetic Neuropathy. Muscle & Nerve. 1996;19(10):1268-75.
Ramji N, Toth C, Kennedy J, Zochodne DW. Does Diabetes Mellitus Target Motor Neurons? Neurobiology of Disease. 2007;26(2):301-11