Structured exercise program on Foot Biomechanics & Insulin Resistance among people living with type 2 diabetes with and without peripheral neuropathy

Abstract

Background: The biomechanical changes in foot among people with type 2 diabetes mellitus often leads to various foot complications which could further add to diabetes related morbidity mortality. These changes could be seen due to musculoskeletal factor like reduction in intrinsic foot muscle strength, tightness of lower limb muscles, postural changes, etc.
 Aim: To design and determine the efficacy of a structured exercise program on foot kinetics and kinematics among type 2 participants
 Materials and methods: A total of 35 participants with type 2 diabetes (n=15, type 2 diabetes mellitus without neuropathy and n=20, type 2 diabetes with peripheral neuropathy) were recruited. All participants were screened clinically biochemically and given a set of structured exercise program, three times a week for 12weeks along with standard medical care.
 Results: The mean age of the participants was 5610.5 (Non neuropathy) 62.37.35 (Neuropathy) years, mean duration of diabetes was 8.78.95 (Non neuropathy), 10.978 (Neuropathy) years, mean Body mass index was 26.54 4.83(Non neuropathy), 24.393.58 (Neuropathy), Significant differences have been observed in kinetic and kinematic variables.
 Conclusion: The present study shows that the structured exercise protocol is very effective in improving the biomechanics of foot in people with type 2 diabetes with and without neuropathy. It could help to correct the structure and function of the foot and eventually could reduce the risk of foot complications like diabetic foot ulcers.

Clinical and biomechanical effectiveness of foot‐ankle exercise programs and weight‐bearing activity in people with diabetes and neuropathy: A systematic review and meta‐analysis

“…Melai et al 4 found lower barefoot peak plantar pressure changes during gait between the intervention and control groups at baseline, 12, 24 or 52 weeks (p < 0.05; only figures provided, no quantification of differences given), but given the existing differences at baseline, no time effect was found and it was concluded that the intervention did not improve plantar pressures compared to control. Of the 7 noncontrolled studies, 2 reported an increase in plantar pressure, 29,30 4 reported a reduction, [31][32][33][34] and 1 reported a reduction in some but no change in most measured locations 35 (Appendix 3).…”

Development of Gymnastics Models to Lower the Risk of Diabetic Ulcers in Diabetics

“…However, comprehensive and structured exercises to improve foot biomechanics in type 2 diabetes mellitus are still lacking, so special exercises are needed to control and prevent musculoskeletal changes and complications in the legs [20]. Gymnastics performed by people with diabetes to lower the risk of diabetic foot ulcers is still focused on the foot area only.…”