A Systematic Review and Meta-analysis on Efficacy of Exercise on Posture and Balance in Patients Suffering from Diabetic Neuropathy

Thukral, Neerja; Kaur, Jaspreet; Malik, Manoj

doi:10.2174/1573399816666200703190437

Cited by 18 publications

(9 citation statements)

References 28 publications

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“…Upon reviewing the literature, there is support that exercise-based interventions ≥4 weeks are beneficial for patients with DPN. This conclusion falls in line with other recently conducted literature reviews investigating the effects of exercise on enhancing gait function [ 156 ], decreasing neuropathic pain [ 157 ], and improving posture and balance among patients with peripheral neuropathy [ 158 ]. However, though the results of this review find various modalities of exercise to be beneficial, the effects are quite numerous and at times, inconsistent.…”

Section: Discussionsupporting

confidence: 91%

The Application of Exercise Training for Diabetic Peripheral Neuropathy

Holmes

Hastings

2021

JCM

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Diabetic peripheral neuropathy (DPN) is the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes. It is associated with pain, paresthesia, sensory loss, muscle atrophy with fat infiltration, and muscular dysfunction typically starting distally in the feet and progressing proximally. Muscle deterioration within the leg and foot can lead to muscle dysfunction, reduced mobility, and increases the risk of disability, ulceration, and amputation. Exercise training is an established method for increasing the different components of physical fitness, including enhancing body composition and improving neuromuscular strength. A number of experimental studies have utilized exercise training to treat various impairments associated with DPN, such as nerve conduction velocity, pain tolerance, and balance. However, the broad spectrum of exercise training modalities implemented and differences in target outcome measurements have made it difficult to understand the efficacy of exercise training interventions or provide appropriate exercise prescription recommendations. Therefore, the aims of this review were to (1) briefly describe the pathophysiology of DPN and (2) discuss the effects of exercise training interventions on sensorimotor, metabolic, and physical functions in people with DPN.

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Section: Discussionsupporting

confidence: 91%

The Application of Exercise Training for Diabetic Peripheral Neuropathy

Holmes

Hastings

2021

JCM

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“…This reminds the future analysis could conduct subgroup analysis based on different participants (T2DM with or without DPN) if there are enough studies. Consistent with a previous review, 47 various exercise interventions had a significant effect in improving BBS and posture stability in diabetes patients. A recent systematic review 25 showed that Tai Chi did not exert an impact on balance (single leg stance test), but it just pooled data from 2 studies.…”

Section: Discussionsupporting

confidence: 88%

The Effects of Exercise Interventions on Balance Capacity in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Qin

Zhao²,

Chen

et al. 2021

INQUIRY

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The effect of exercise intervention on balance capacity among type 2 diabetes mellitus (T2DM) patients has not been evaluated. The objective of this systematic review and meta-analysis is to investigate the effect of exercise intervention on balance capacity among T2DM patients compared to the control group (usual care, waitlist, no-treatment, education). We conducted a comprehensive literature search through PubMed, EMBASE, Physiotherapy Evidence Database (PEDro), Cochrane library, Web of Science (WOS) from inception to August 2020. The literature language was limited to English. Randomized controlled trials (RCTs) or quasi-experimental (Q-E) trials that examined the effect of exercise intervention on balance capacity among T2DM patients were included. We used the standard methods of meta-analysis to evaluate the outcomes of exercise intervention for balance capacity of T2DM patients. A total of 14 trials (11 RCTs and 3 Q-E trials) involving 883 participants were eligible. The meta-analysis of some studies demonstrated that exercise intervention could significantly improve Berg Balance Scale (BBS) (MD = 2.56; 95%CI [0.35, 4.77]; P = .02), SLST (Single Leg Stance Test) under the eyes-open (EO) condition (MD = 3.63; 95%CI [1.79, 5.47]; P = .0001) and eyes-close (EC) condition (MD = 0.41; 95%CI [0.10, 0.72]; P = .01) compared to control group. There was no significant difference in Time Up and Go Test (TUGT) (MD = −0.75; 95%CI [−1.69, 0.19]; P = .12) and fall efficacy (SMD = −0.44; 95%CI [−0.86, −0.01]; P = .05). Narrative review of some studies indicated that exercise intervention could improve postural stability measured by Sensory Organization Test (SOT) and Center of Pressure (COP) variables, etc. This systematic review and meta-analysis summarized that exercise intervention could improve balance capacity in T2DM patients. However, further studies with high quality are required to evaluate its effect.

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“…In a systematic review by Tofthagen et al [ 36 ], the authors summarise the existing literature on the effectiveness of plyometric and balance training interventions in people at high risk of falls and conclude that plyometric and balance training is recommended to be safe and effective in older people at high risk of falls and in the DPN population. A systematic review and meta-analysis by Thukral et al [ 37 ], in which 18 randomized controlled trials were also pooled, showed that the use of different exercises (e.g. balance exercises, core stability exercises, Tai Chi, proprioceptive exercises, etc.)…”

Section: Discussionmentioning

confidence: 99%

The influence of diabetes and age-related degeneration on body balance control during static standing: a study based on plantar center-of-pressure trajectories and principal component analysis

Hu,

Yang,

Wang

et al. 2023

J Orthop Surg Res

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Background Aging and diabetes can impair the balance function of the elderly and diabetic patients and increase their fall risk. This study aimed to assess the shaking amplitude of the center-of-pressure (CoP) during static standing, to analyze the effects of aging and diabetes on the balance control. Materials and methods This cross-sectional observational study, compared the balance performance of 20 healthy younger adults (27.65 ± 5.60 years), 16 healthy older adults (58.88 ± 3.54 years) and 15 diabetic patients (58.33 ± 5.33 years) in four static standing conditions on a force plate: horizontal, anteroposterior (AP), left and right slope planes (5° angles on AP, left and right directions, respectively). The trajectory coordinates of the CoP over time were recorded and analyzed by principal components analysis to obtain the 95% confidence ellipse and its parameters: angle, major and minor axes lengths, and area. The balance indicators were compared among the three groups using one-way analysis of variance (ANOVA), Brown–Forsythe test or Kruskal–Wallis H test, depending on the normality and homogeneity of variance assumptions. Results The diabetic group had a significantly larger confidence ellipse area than the healthy younger adults on the horizontal plane (P = 0.032) and than the healthy older adults on the horizontal (P = 0.036), AP slope (P = 0.023), and right ML slope (P = 0.037) planes. There were no significant differences in the major axis length of the confidence ellipse among the three groups. The diabetic group had a significantly longer minor axis length than the healthy younger adults on the AP slope (P = 0.039), left ML slope (P = 0.045) and right ML slope (P = 0.016) planes and than the healthy older adults on the AP slope (P = 0.007), left ML slope (P = 0.035) and right ML slope (P = 0.012) planes. Conclusions The balance control of diabetic patients is decreased compared with healthy younger and older people, and the body swing amplitude increases mainly in the direction of minor axis of confidence ellipse during static standing, while the swing amplitude in the direction of the major axis has no significant change. Evaluating the balance function of diabetic patients can help clinicians identify people with fall risk early and intervene early, thereby reducing the occurrence of fall events in this population.

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A Systematic Review and Meta-analysis on Efficacy of Exercise on Posture and Balance in Patients Suffering from Diabetic Neuropathy

Cited by 18 publications

References 28 publications

The Application of Exercise Training for Diabetic Peripheral Neuropathy

The Application of Exercise Training for Diabetic Peripheral Neuropathy

The Effects of Exercise Interventions on Balance Capacity in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

The influence of diabetes and age-related degeneration on body balance control during static standing: a study based on plantar center-of-pressure trajectories and principal component analysis

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