Effect of Aerobic Exercise with and without Strengthening Exercises on Neuropathic Symptoms in People with Diabetic Peripheral Neuropathy
Article Sidebar
Main Article Content
Abstract
Background: The incidence of peripheral neuropathy among chronic diabetic patients is escalating, with a notable rise observed in Pakistan. This trend has been partly attributed to the predominant reliance on pharmacotherapy, while the role of physical exercise in management remains underutilized. Aerobic exercise is widely recommended in clinical guidelines for the treatment and prevention of diabetic complications, and it is hypothesized that the addition of strength training could yield even more benefits.
Objective: This study aimed to evaluate the effects of combined aerobic and strength training exercises on neuropathic symptoms in patients with diabetic peripheral neuropathy.
Methods: In this randomized clinical trial, 40 patients with diabetic peripheral neuropathy were equally divided into two groups: Group A underwent a combined regimen of aerobic and strength training exercises, whereas Group B engaged in aerobic exercises alone. The effectiveness of these interventions was assessed using the Michigan Neuropathy Screening Instrument (MNSI), Numeric Pain Rating Scale (NPRS), and Clinical Global Impression of Change (CGIC). Data were analyzed using SPSS version 20.0, employing independent t-tests, repeated measures ANOVA, and descriptive statistics for in-depth analysis.
Results: Group A demonstrated a significant reduction in MNSI scores with a mean difference of 1.700 and a p-value < 0.001, indicating a substantial improvement in neuropathic symptoms compared to Group B. While both groups showed significant improvements in NPRS and CGIC scores, the differences were not statistically significant, with p-values of 0.599 and 0.330, respectively, and mean differences of 0.1500 and 0.2500 for NPRS and CGIC. The overall statistical analysis revealed a high significance level (p < 0.001) within both groups in all measured outcomes, suggesting considerable improvements post-intervention.
Conclusion: The addition of strength training to aerobic exercises significantly enhances the reduction of neuropathic symptoms in diabetic patients. However, for pain relief and overall clinical improvement, both treatment approaches—combined aerobic and strength training or aerobic exercise alone—were equally effective.
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;19:1-8.
Group TS. Risk factors for diabetic peripheral neuropathy in adolescents and young adults with type 2 diabetes: results from the TODAY study. Diabetes care. 2022;45(5):1065-72.
Liu X, Xu Y, An M, Zeng Q. The risk factors for diabetic peripheral neuropathy: a meta-analysis. PloS one. 2019;14(2):e0212574.
Abdissa D, Hamba N, Kene K, Bedane DA, Etana G, Muleta D, et al. Prevalence and determinants of peripheral neuropathy among type 2 adult diabetes patients attending Jimma University Medical Center, Southwest Ethiopia, 2019, an institutional-based cross-sectional study. Journal of Diabetes Research. 2020;2020.
Li L, Zhang S, Dobson J. The contribution of small and large sensory afferents to postural control in patients with peripheral neuropathy. Journal of sport and health science. 2019;8(3):218-27.
Arif S, Shafee I, Riaz N, Waris I, Hayat M, Jamal MN, et al. Association of Lower Extremity Somatosensation Deficit with Balance and Gait in Sub-Acute Stroke Patients. Pakistan Journal of Medical & Health Sciences. 2022;16(09):454-.
Viseux FJ. The sensory role of the sole of the foot: Review and update on clinical perspectives. Neurophysiologie Clinique. 2020;50(1):55-68.
Sempere‐Bigorra M, Brognara L, Julian‐Rochina I, Mazzotti A, Cauli O. Relationship between deep and superficial sensitivity assessments and gait analysis in diabetic foot patients. International Wound Journal. 2023.
Bönhof GJ, Herder C, Ziegler D. Diagnostic tools, biomarkers, and treatments in diabetic polyneuropathy and cardiovascular autonomic neuropathy. Current Diabetes Reviews. 2022;18(5):156-80.
Filipović N, Marinović Guić M, Košta V, Vukojević K. Cardiac innervations in diabetes mellitus—Anatomical evidence of neuropathy. The Anatomical Record. 2023;306(9):2345-65.
Mezil SA, Abed BA. Complication of diabetes mellitus. Annals of the Romanian Society for Cell Biology. 2021:1546-56.
Johnson NA, Keating SE, Coombes JS. AEROBIC EXERCISE. ESSA’s Student Manual for Exercise Prescription, Delivery and Adherence-eBook. 2019:84.
Alexander L, Christensen SM, Richardson L, Ingersoll AB, Burridge K, Golden A, et al. Nutrition and physical activity: an obesity medicine association (OMA) clinical practice statement 2022. Obesity Pillars. 2022;1:100005.
Nagappa KT, Martin K. Effects of aerobic exercises, and meditation on endurance variable of school children. 2019.
Tola GA. EFFECT OF AEROBIC EXERCISES ON PHYSICAL FITNESS, PHYSIOLOGICAL VARIABLES AND ANTHROPOMETRIC VALUE ON U-17 MALE FOOTBALL PROJECT PLAYERS; THE CASE OF SEMEN MEZEGAJA, ARADA SUB-CITY ADMINISTRATION, ADDIS ABABA, ETHIOPIA: Haramaya University; 2023.
Müller J, Weiler M, Schneeweiss A, Haag GM, Steindorf K, Wick W, et al. Preventive effect of sensorimotor exercise and resistance training on chemotherapy-induced peripheral neuropathy: A randomised-controlled trial. British journal of cancer. 2021;125(7):955-65.
Lin W-L, Wang R-H, Chou F-H, Feng I-J, Fang C-J, Wang H-H. The effects of exercise on chemotherapy-induced peripheral neuropathy symptoms in cancer patients: a systematic review and meta-analysis. Supportive Care in Cancer. 2021;29:5303-11.
Tanay MAL, Armes J, Moss-Morris R, Rafferty AM, Robert G. A systematic review of behavioural and exercise interventions for the prevention and management of chemotherapy-induced peripheral neuropathy symptoms. Journal of cancer survivorship. 2021:1-24.
Yoo SH, Kim W-j, Chae JS, Kang BK, Kang MJ, Beak MH. Efficacy of scrambler therapy in patients with painful diabetic peripheral neuropathy: A single-arm, prospective, pilot study. Medicine. 2023;102(39):e35357.
Bennedsgaard K, Ventzel L, Andersen NT, Themistocleous AC, Bennett DL, Jensen TS, et al. Oxaliplatin‐and docetaxel‐induced polyneuropathy: clinical and neurophysiological characteristics. Journal of the Peripheral Nervous System. 2020;25(4):377-87.
Ogle T, Alexander K, Miaskowski C, Yates P. Systematic review of the effectiveness of self-initiated interventions to decrease pain and sensory disturbances associated with peripheral neuropathy. Journal of Cancer Survivorship. 2020;14:444-63.
McMillin CR. Resistance Training Dose Selection and Management Methods for Patients with Persistent Symptoms of Lyme Disease: Concordia University Chicago; 2023.
Alnajafi KZ-S. The Impact of Intraneural Facilitation Therapy on Diabetic Peripheral Neuropathy. 2021.
Nweke MC. Effects of a 12-week aerobic exercise programme on human immunodeficiency virus-associated neurocognitive disorder in Nigeria: University of Pretoria; 2021.
Shabbir M, Gul I, Asghar E, Muhammad N, Mehjabeen H, Rafiq I, et al. Effectiveness Of Maitland’s Mobilization And Conventional Physical Therapy On Synovial Biomarkers In Patients With Knee Osteoarthritis; A Randomized Control Trial. Webology. 2022;19(2).
STRENGTH OQ. Dr Abdul Hannan PT1, Dr Madiha Younas PT2, Dr. Sabahat Ali sheikh PT3, Dr. Akhtar Rasul PT4, Dr Sania Anwar PT5, Dr. Misdaq Batool PT6 1Student Riphah international university Lahore, Pakistan 2Senior lecturer Riphah international university Lahore, Pakistan 3, 5Lecturer University of Lahore, Sargodha campus, Pakistan.