Controle postural e equilíbrio funcional em indivíduos com neuropatia diabética periférica

Fortaleza, Ana Claudia de Souza; Chagas, Eliane Ferrari; Ferreira, Dalva Minonroze Albuquerque; Mantovani, Alessandra Madia; Barela, José Ângelo; Chagas, Eduardo Federighi Baisi; Fregonesi, Cristina Elena Prado Teles

doi:10.5007/1980-0037.2013v15n3p305

Cited by 5 publications

(3 citation statements)

References 26 publications

(26 reference statements)

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“…In addition, in condition 2 with the restriction of higher joints, the mean changes in the APSI and MLSI were about 25% and 9%, respectively. These findings are in line with those obtained by Fortaleza who reported that in diabetic neuropathic patients with sensory impairment of ankle, AP sway was more affected by visual input than ML (44). As a result, the restriction of visual and vestibular systems, as well as the movement of the upper segments, caused more significant changes in AP direction.…”

Section: Discussionsupporting

confidence: 92%

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Dynamic balance and neuropathic changes following ankle proprioceptive training in type II diabetic patients with peripheral neuropathy

Ravand

Ghasemi

Rahimi

et al. 2021

ircmj

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Introduction: Peripheral neuropathy is one of the major complications of type II diabetes mellitus. Lower limb proprioceptive impairments due to neuropathy can lead to balance disorders in these patients. The present study aimed to investigate postural stability and neuropathic changes following ankle proprioceptive training in type II diabetic patients with moderate neuropathy. Materials and Methods: The present study was conducted on 24 type II diabetic patients with moderate neuropathy (9 females and 15 males) aged 40-65 years (with a mean age of 57.25 years). The treatment consisted of ankle proprioceptive training by the balance board and rocker for 10 consecutive days. Balance indices, including Overall Stability Index (OSI), Anterior-Posterior Stability Index (APSI), and Medial-Lateral Stability Index (MLSI), were measured with Biodex system before and after the treatment, as well as two weeks after treatment in two conditions: condition1: Eyes open, head straight, without using trunk, pelvis, thigh, and knee constrained orthosis. Condition 2: Eyes closed, head back (hyperextension), with using trunk, pelvis, thigh, and knee constrained orthosis. Plate-based Biodex stability was fixed at levels 6 and 8 for condition1 and level 8 for condition 2. The severity of neuropathy was assessed using Valk and Michigan questionnaires, as well as light touch sensation. The analysis of variance with repeated measure was used to evaluate alterations in the stability of patients. Furthermore, the correlation of neuropathic changes and stability parameters were assessed by the Pearson correlation coefficients. Results: Significant improvements were observed in OSI in all tests of condition 1 (Biodex Balance System (BBS) at level 8 (P=0.001) and level 6 (P=0.017), as well as test conditions 2 (level 8; P=0.004). After the treatment, at stability level 8, a significant improvement in the mean values of postural sways in the Anterior-Posterior (AP) direction demonstrated that the ankle strategy was improved in the patients. After the treatment, the scores of the Valk (P=0.02) and Michigan (P=0.001) questionnaires were significantly decreased. After two weeks of follow-up, the observed improvement was maintained in the mean values of balance indices (OSI, APSI) and neuropathy due to treatment. Conclusion: As evidenced by the obtained results, 10 sessions of targeted ankle proprioceptive training improved stability, neuropathy, and light touch sensation of the foot in type II diabetic patients with moderate neuropathy. Foot somatosensory information is one of the most important causes of balance alterations in these patients

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Section: Discussionsupporting

confidence: 92%

“…Furthermore, evaluation in different conditions provides a deeper understanding of the relationship between sensory and motor afferents (44).…”

Section: Discussionmentioning

confidence: 99%

Dynamic balance and neuropathic changes following ankle proprioceptive training in type II diabetic patients with peripheral neuropathy

Ravand

Ghasemi

Rahimi

et al. 2021

ircmj

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“…Eles constataram que houve melhora no deslocamento do plano médio-lateral. Bonfim et al (2007) Nessa abordagem, a intervenção proposta neste estudo concorda com as conclusões de Fortaleza et al (2013) e Iunes et al (2014), os quais ratificaram a necessidade de programas de reabilitação para trabalhar com os componentes sensoriais por meio de exercícios terapêuticos.…”

Section: Discussionunclassified

Análise da resposta neuromuscular, equilíbrio postural e qualidade de vida em diabéticos tipo 2 após treinamento sensório-motor: ensaio clínico randomizado controlado cego

Pletsch¹

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O Diabetes Mellitus tipo 2 (DM-2) é uma doença crônica degenerativa com alta prevalência, e considerada um grande problema de Saúde Pública que tem como complicações o deficit funcional de membros inferiores e as quedas que podem interferir na manutenção do equilíbrio, além de reduzir a qualidade de vida (QV). Assim, o objetivo foi analisar a resposta neuromuscular, equilíbrio postural e qualidade de vida de DM-2, após o treinamento sensório-motor supervisionado e domiciliar. O ensaio clínico randomizado cego foi conduzido com oitenta DM-2, faixa etária entre 45 a 64 anos, de ambos os sexos, randomizados em três grupos: GC-Grupo Controle (n=27), GT-D-Grupo Treinamento Domiciliar (n=27) e GT-S-Grupo Treinamento Supervisionado (n=26). A intervenção foi realizada por 12 semanas, 2 vezes por semana, sendo dividida em três fases: aquecimento, treinamento sensório-motor e desaquecimento, com monitoramento da pressão arterial e glicemia. A variável de desfecho foi o equilíbrio estático, sendo avaliado ainda a sensibilidade tátil e vibratória, sinais e sintomas de polineuropatia diabética, qualidade de vida, sinal eletromiográfico e isocinético de flexo-extensores de joelhos. Foi aplicado o teste de Wilcoxon para as comparações entre os tempos pré e pós-intervenção e Kruskal-Wallis, seguido de post hoc Dunn, para as comparações intergrupos, e correção de Bonferroni, com nível de significância de 5% e o coeficiente d de Cohen para descrição do tamanho do efeito da intervenção. A sensibilidade tátil e vibratória demonstrou ausência de sintomas de neuropatia periférica nos pacientes diabéticos. Na comparação intragrupo, houve aumento significativo da classificação sem sintomas de polineuropatia distal diabética nos grupos GT-D e GT-S (p<0,05) e na comparação intergrupo houve diferença significativa para a amplitude de deslocamento médio-lateral com olhos abertos, entre os grupos GT-D e GT-S (p<0,05). As avaliações isocinéticas e eletromiográficas não apresentaram diferença significativa, seja intra ou intergrupo. Conclui-se que o protocolo de intervenção influenciou positivamente apenas no equilíbrio postural estático na amplitude de deslocamento médio-lateral nos DM-2 tratados em domicílio, mas não influenciou na Qualidade de Vida, na atividade eletromiográfica, na força muscular e no senso de posição articular de joelho.

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The effects of in-water and on-land aerobic training on postural sway and balance in patients with type 2 diabetes

Abasgholipour

Shahbazi

Boroujeni

et al. 2021

Int J Diabetes Dev Ctries

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Controle postural e equilíbrio funcional em indivíduos com neuropatia diabética periférica

Abstract: Grupo de Estudos Mecanismos periféricos da regulação cardiovascular induzidos pelo treinamento físico em diferentes situações.

Cited by 5 publications

References 26 publications

Dynamic balance and neuropathic changes following ankle proprioceptive training in type II diabetic patients with peripheral neuropathy

Dynamic balance and neuropathic changes following ankle proprioceptive training in type II diabetic patients with peripheral neuropathy

Análise da resposta neuromuscular, equilíbrio postural e qualidade de vida em diabéticos tipo 2 após treinamento sensório-motor: ensaio clínico randomizado controlado cego

The effects of in-water and on-land aerobic training on postural sway and balance in patients with type 2 diabetes

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