Exercise-facilitated Neurorehabilitation in Diabetic Neuropathy
Exercise-Facilitated NeuroRehabilitation in Diabetic Neuropathy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Illinois
-
Hines, Illinois, United States, 60141-5000
- Edward Hines Jr. VA Hospital, Hines, IL
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Clinical diagnosis of type 2 diabetes mellitus
- stable blood glucose control
- clinical findings consistent with length-dependent sensorimotor polyneuropathy, stage N2a
Exclusion Criteria:
- foot ulceration
- unstable heart disease
- co-morbid conditions limiting exercise
- disorders of the central nervous system causing weakness or sensory loss
- received treatment with medications known to have neuropathy as a prominent side effect including vincristine, vinblastine, cis-platin, and paclitaxel
- medical conditions that may be associated with neuropathies such as alcoholism, liver disease, kidney disease, toxic exposure, vitamin deficiency, autoimmune disorders, cancer, or hypothyroidism
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Arm 1
Sedentary Control Group
|
|
|
Experimental: Arm 2
Aerobic Exercise Group
|
Structured aerobic exercise (treadmill).
Structured isokinetic strength exercise (dynameter).
|
|
Experimental: Arm 3
Isokinetic Strength Exercise Group
|
Structured aerobic exercise (treadmill).
Structured isokinetic strength exercise (dynameter).
|
|
Experimental: Arm 4
Combined Aerobic and Isokinetic Strength Exercise Group
|
Structured aerobic exercise (treadmill).
Structured isokinetic strength exercise (dynameter).
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Sural Nerve Amplitude
Time Frame: Baseline, 12, and 24 weeks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Sensory nerve action potentials were recorded from sural (antidromic), median (antidromic to second digit), and ulnar nerves (antidromic to fifth digit).To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12, and 24 weeks
|
|
Sural Nerve Latency
Time Frame: Baseline, 12 wks, 24 wks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Sensory nerve action potentials were recorded from sural (antidromic), median (antidromic to second digit), and ulnar nerves (antidromic to fifth digit).To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 wks, 24 wks
|
|
Sural Nerve Conduction Velocity
Time Frame: Baseline, 12 wks, 24 wks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Sensory nerve action potentials were recorded from sural (antidromic), median (antidromic to second digit), and ulnar nerves (antidromic to fifth digit).To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 wks, 24 wks
|
|
Tibial Nerve Amplitude
Time Frame: Baseline, 12 weeks, 24 weeks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Distal motor nerve evoked compound muscle action potential (CMAP) potentials were recorded from tibial and peroneal nerves.To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 weeks, 24 weeks
|
|
Tibial Nerve Latency
Time Frame: Baseline, 12 weeks, 24 weeks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Distal motor nerve evoked compound muscle action potential (CMAP) potentials were recorded from tibial and peroneal nerves.To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 weeks, 24 weeks
|
|
Tibial Nerve Conduction Velocity
Time Frame: Baseline, 12 weeks, 24 weeks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Distal motor nerve evoked compound muscle action potential (CMAP) potentials were recorded from tibial and peroneal nerves.To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 weeks, 24 weeks
|
|
Sensory Median Nerve Amplitude
Time Frame: Baseline, 12, and 24 weeks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Sensory nerve action potentials were recorded from sural (antidromic), median (antidromic to second digit), and ulnar nerves (antidromic to fifth digit).To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12, and 24 weeks
|
|
Sensory Median Nerve Latency
Time Frame: Baseline, 12wks, 24 wks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Sensory nerve action potentials were recorded from sural (antidromic), median (antidromic to second digit), and ulnar nerves (antidromic to fifth digit).To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12wks, 24 wks
|
|
Sensory Median Nerve Conduction Velocity
Time Frame: Baseline, 12 wks, 24 wks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Sensory nerve action potentials were recorded from sural (antidromic), median (antidromic to second digit), and ulnar nerves (antidromic to fifth digit).To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 wks, 24 wks
|
|
Sensory Ulnar Nerve Amplitude
Time Frame: Baseline, 12 wks, 24 wks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Sensory nerve action potentials were recorded from sural (antidromic), median (antidromic to second digit), and ulnar nerves (antidromic to fifth digit).To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 wks, 24 wks
|
|
Sensory Ulnar Nerve Latency
Time Frame: Baseline, 12 wks, 24 wks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Sensory nerve action potentials were recorded from sural (antidromic), median (antidromic to second digit), and ulnar nerves (antidromic to fifth digit).To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 wks, 24 wks
|
|
Sensory Ulnar Nerve Conduction Velocity
Time Frame: Baseline, 12 wks, 24 wks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Sensory nerve action potentials were recorded from sural (antidromic), median (antidromic to second digit), and ulnar nerves (antidromic to fifth digit).To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 wks, 24 wks
|
|
Peroneal Nerve Amplitude
Time Frame: Baseline, 12 wks, 24 wks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Distal motor nerve evoked compound muscle action potential (CMAP) potentials were recorded from tibial and peroneal nerves.To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 wks, 24 wks
|
|
Peroneal Nerve Latency
Time Frame: Baseline, 12 wks, 24 wks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Distal motor nerve evoked compound muscle action potential (CMAP) potentials were recorded from tibial and peroneal nerves.To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 wks, 24 wks
|
|
Peroneal Nerve Conduction Velocity
Time Frame: Baseline, 12 wks, 24 wks
|
Maximal responses were obtained using percutaneous electrical stimuli.
Distal motor nerve evoked compound muscle action potential (CMAP) potentials were recorded from tibial and peroneal nerves.To minimize inter-examiner variability and maximize neurophysiologic test/retest reliability, the same experienced neurologist conducted all nerve conduction studies on days separate from all other testing activities.
A dedicated TECA Synergy electromyograph system was used for all nerve conduction studies.
The patients dominant side was chosen.
In patients with definable differences between the two sides, the side with the most prominent clinical findings was chosen.
In all cases, the same limb was used for all three (baseline, 12-weeks, 24-weeks) conduction studies.
|
Baseline, 12 wks, 24 wks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Symptom-Limited TMT Blood Glucose Response
Time Frame: Initial entry into study, 12 and 24 weeks
|
Changes in blood glucose in response to modified Bruce Protocol treadmill test (TMT)
|
Initial entry into study, 12 and 24 weeks
|
|
Short Form-36V: Physical Component Score
Time Frame: Initial entry into study, 12 and 24 weeks
|
The short form-36Veterans (SF-36V) health survey questionnaire was used to measure health-related quality of life.
This survey is comprised of eight subscales and two overall component scores, all of which have demonstrated high levels of internal consistency and discriminate validity when administered to groups of medically stable individuals.
Patient aggregate responses for the eight distinct summary subscales and two component scores were compiled as a percentage of total points possible using the RAND 36-item health survey table.
Data shown are expressed as a percentage of total possible score ranging from 0%-100% with 100% considered relatively good health and 0% considered poor health.
Physical Component scores reflect perceived changes in physical health relative to the previous year.
|
Initial entry into study, 12 and 24 weeks
|
|
Voluntary Duration of Symptom-Limited TMT
Time Frame: baseline, 12-wks, 24-wks
|
Total time subjects voluntarily exercised while undergoing a modified Bruce Protocol treadmill test (TMT)
|
baseline, 12-wks, 24-wks
|
|
Symptom-Limited TMT Maximum Heart Rate
Time Frame: baseline, 12-wks, 24-wks
|
Peak heart rate achieved while undergoing a modified Bruce Protocol treadmill test (TMT)
|
baseline, 12-wks, 24-wks
|
|
Symptom-Limited TMT Maximum Systolic Blood Pressure
Time Frame: Baseline, 12-wk, 24-wk
|
Peak systolic BP achieved while undergoing a modified Bruce Protocol treadmill test (TMT)
|
Baseline, 12-wk, 24-wk
|
|
Symptom-Limited TMT Maximum Minute Ventilation (VE)
Time Frame: Baseline, 12-wks, 24-wks
|
Peak volume of air exchanged per minute achieved while undergoing a modified Bruce Protocol treadmill test (TMT)
|
Baseline, 12-wks, 24-wks
|
|
Symptom-Limited TMT Maximum Oxygen Uptake (VO2)
Time Frame: Baseline, 12-wks, 24-wks
|
Peak Oxygen uptake achieved while undergoing a modified Bruce Protocol treadmill test (TMT)
|
Baseline, 12-wks, 24-wks
|
|
Maximum Respiratory Exchange Ratio (RER) During TMT
Time Frame: Baseline, 12-wks, 24-wks
|
Peak RER achieved while undergoing a modified Bruce Protocol treadmill test (TMT).
This is a mathematical ratio of maximally achieved (peak) VCO2 divided by maximally achieved (peak) VO2.
|
Baseline, 12-wks, 24-wks
|
|
Symptom-Limited TMT Maximum Carbon Dioxide Expelled (VCO2)
Time Frame: Baseline, 12-wks, 24-wks
|
Peak Carbon Dioxide expelled achieved while undergoing a modified Bruce Protocol treadmill test (TMT)
|
Baseline, 12-wks, 24-wks
|
|
Symptom-Limited TMT Maximum METS Achieved (MET)
Time Frame: Baseline, 12-wks, 24-wks
|
Peak metabolic rate equivalents (METS) achieved while undergoing a modified Bruce Protocol treadmill test (TMT).
One MET is defined as the metabolic rate observed at rest, quantified as resting oxygen consumption of 250 ml/min (Male) or 200 ml /min (female).
A value of 5 METS would represent a metabolic rate that is 5x that at rest and is considered an indicator of how hard a given individual is exercising.
Data shown are expressed as a ratio at peak of exercise of oxygen consumed relative to normalized values for men or women at rest.
|
Baseline, 12-wks, 24-wks
|
|
Short Form-36V: Mental Component Score
Time Frame: initial entry into study, and at 12-wks and 24-wks
|
The short form-36Veterans (SF-36V) health survey questionnaire was used to measure health-related quality of life.
This survey is comprised of eight subscales and two overall component scores, all of which have demonstrated high levels of internal consistency and discriminate validity when administered to groups of medically stable individuals.
Patient aggregate responses for the eight distinct summary subscales and two component scores were compiled as a percentage of total points possible using the RAND 36-item health survey table.
Data shown are expressed as a percentage of total possible score ranging from 0%-100% with 100% considered relatively good health and 0% considered poor health.
Mental Component scores reflect perceived changes in emotional health relative to the previous year.
|
initial entry into study, and at 12-wks and 24-wks
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Height
Time Frame: baseline
|
Height of subjects upon entry into study
|
baseline
|
|
Weight
Time Frame: Baseline, 12-wks, 24-wks
|
Weight of subjects at baseline, 12-weeks, and 24-weeks
|
Baseline, 12-wks, 24-wks
|
|
Body Mass Index (BMI)
Time Frame: Baseline, 12-wk, 24-wk
|
BMI is calculated as a ratio of subject body mass (kg) divided by the square of subject height (m).
|
Baseline, 12-wk, 24-wk
|
|
Duration of Diabetes Mellitus
Time Frame: Baseline
|
Duration, in years, since first diagnosed with Diabetes Mellitus upon entry into study
|
Baseline
|
|
HbA1C Laboratory Values
Time Frame: Baseline, 12-wk, 24-wk
|
Laboratory values of subject HbA1C levels at Baseline, 12-wk, 24-wk
|
Baseline, 12-wk, 24-wk
|
|
Triglyceride Laboratory Values
Time Frame: Baseline
|
Laboratory triglyceride values at baseline entry into study
|
Baseline
|
|
Cholesterol Laboratory Values
Time Frame: Baseline
|
Laboratory total cholesterol, HDL-cholesterol, and LDL-cholesterol levels at baseline entry into study
|
Baseline
|
|
Creatinine Laboratory Values
Time Frame: Baseline
|
Laboratory creatinine values at baseline entry into study
|
Baseline
|
|
Blood Urea Nitrogen (BUN) Laboratory Values
Time Frame: Baseline
|
Laboratory Blood Urea Nitrogen levels at baseline entry into study
|
Baseline
|
|
Aspartate Aminotransferase Laboratory Values
Time Frame: Baseline
|
Laboratory values for Aspartate Aminotransferase (AST) at baseline entry into study
|
Baseline
|
|
Thyroid Stimulating Hormone Laboratory Values
Time Frame: Baseline
|
Laboratory values for Thyroid Stimulating Hormone (TSH) at baseline entry into study
|
Baseline
|
|
Age
Time Frame: at baseline
|
Age of participants at entry into study.
|
at baseline
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Evan Stubbs, Edward Hines Jr. VA Hospital, Hines, IL
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- B6954-R
- I01RX000130 (U.S. NIH Grant/Contract)
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