The effect of exercise therapy on balance in patients with diabetic peripheral neuropathy: a systematic review

Narges Jahantigh Akbari, Sedigheh Sadat Naimi, Narges Jahantigh Akbari, Sedigheh Sadat Naimi

Abstract

Background: Peripheral sensory and motor nerves are often affected in people with diabetes mellitus (DM), and balance problems are widespread. Diabetic peripheral neuropathy is common. This study investigated the impact of exercise treatment on balance parameters in diabetic peripheral neuropathy patients.

Method: Electronic databases, such as PubMed, Web of Science, and Science Direct, were used to perform a search of accessible papers. The search strategy was (exercise therapy OR physical activity) AND (balance OR equilibrium OR postural control OR fall OR fall risk OR static balance OR dynamic balance OR functional balance) AND diabetic peripheral neuropathy. The Physiotherapy Evidence Database (PEDro) scale was used to rate the research in this review for its quality and reliability. Scores ranged from 5 to 9 on the PEDro scale.

Result: According to databases, about 9,103 articles were found in August 2021 from March 1984 to February 2020. From 9103 articles, 3872 were deleted for different reasons, including duplicate, non-randomized controlled trial (RCT) articles and after reviewing the title and abstract. About 5,231 articles were found in free full text. In the end, 12 submissions were approved. These studies investigated the effects of exercise treatment on static, dynamic, and functional balance parameters in diabetic peripheral neuropathy patients.

Conclusions: This study showed the positive effects of balance and strengthening exercise on static balance indices in patients with diabetic peripheral neuropathy.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-022-01077-1.

Keywords: Balance; Exercise therapy; Physical activity; Postural control; Type 2 diabetic neuropathy.

Conflict of interest statement

Conflict of interestThe corresponding author states no conflict of interest on behalf of all authors.

© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2022.

Figures

Fig. 1
Fig. 1
Flow chart of the study

References

    1. Javadzadeh A, Ghorbanihaghjo A, Adl FH, Andalib D, Khojasteh-Jafari H, Ghabili K. Calcium dobesilate reduces endothelin-1 and high-sensitivity C-reactive protein serum levels in patients with diabetic retinopathy. Mol Vis. 2013;19:62.
    1. Rahbar S, Naimi SS, Reza Soltani A, Rahimi A, Akbarzadeh Baghban A, Rashedi V, et al. Improvement in biochemical parameters in patients with type 2 diabetes after twenty-four sessions of aerobic exercise: A randomized controlled trial. Iran Red Crescent Med J. 2017;19(7):2.
    1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53.
    1. Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. J Diabetes Metabolic Disorders. 2013;12(1):1–5.
    1. Dyck PJ, Kratz K, Karnes J, Litchy WJ, Klein R, Pach J, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study. Neurology. 1993;43(4):817.
    1. Eftekhar-Sadat B, Azizi R, Aliasgharzadeh A, Toopchizadeh V, Ghojazadeh M. Effect of balance training with Biodex Stability System on balance in diabetic neuropathy. Ther Adv Endocrinol Metab. 2015;6(5):233–40.
    1. Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28(4):956–62.
    1. Venkataraman K, Tai BC, Khoo EY, Tavintharan S, Chandran K, Hwang SW, et al. Short-term strength and balance training does not improve quality of life but improves functional status in individuals with diabetic peripheral neuropathy: a randomised controlled trial. Diabetologia. 2019;62(12):2200–10.
    1. Sohrabzadeh E, Kalantari KK, Naimi SS, et al. The immediate effect of a single whole-body vibration session on balance, skin sensation, and pain in patients with type 2 diabetic neuropathy. J Diabetes Metab Disord. 2021 doi: 10.1007/s40200-021-00933-w.
    1. Domínguez-Muñoz FJ, Villafaina S, García-Gordillo MA, Hernández-Mocholi M, Collado-Mateo D, Adsuar JC, et al. Effects of 8-week whole-body vibration training on the HbA1c, quality of life, physical fitness, body composition and foot health status in people with T2DM: A double-blinded randomized controlled trial. Int J Environ Res Public Health. 2020;17(4):1317.
    1. Said G. Diabetic neuropathy—a review. Nat Clin Pract Neurol. 2007;3(6):331–40.
    1. Ahmad I, Verma S, Noohu MM, Shareef MY, Hussain ME. Sensorimotor and gait training improves proprioception, nerve function, and muscular activation in patients with diabetic peripheral neuropathy: A randomized control trial. J Musculoskel Neuronal Interact. 2020;20(2):234.
    1. Menz HB, Lord SR, St George R, Fitzpatrick RC. Walking stability and sensorimotor function in older people with diabetic peripheral neuropathy. Arch Phys Med Rehabil. 2004;85(2):245–52.
    1. Lau C-Y, Qureshi A, Scott S. Association between glycaemic control and quality of life in diabetes mellitus. J Postgrad Med. 2004;50(3):189.
    1. Balducci S, Iacobellis G, Parisi L, Di Biase N, Calandriello E, Leonetti F, et al. Exercise training can modify the natural history of diabetic peripheral neuropathy. J Diabetes Complicat. 2006;20(4):216–23.
    1. Allet L, Armand S, De Bie R, Golay A, Monnin D, Aminian K, et al. The gait and balance of patients with diabetes can be improved: a randomised controlled trial. Diabetologia. 2010;53(3):458–66.
    1. Van der Heijden M, van Dooren FE, Pop V, Pouwer F. Effects of exercise training on quality of life, symptoms of depression, symptoms of anxiety and emotional well-being in type 2 diabetes mellitus: a systematic review. Diabetologia. 2013;56(6):1210–25.
    1. Teixeira-Lemos E, Nunes S, Teixeira F, Reis F. Regular physical exercise training assists in preventing type 2 diabetes development: focus on its antioxidant and anti-inflammatory properties. Cardiovasc Diabetol. 2011;10(1):1–15.
    1. Kluding PM, Pasnoor M, Singh R, Jernigan S, Farmer K, Rucker J, et al. The effect of exercise on neuropathic symptoms, nerve function, and cutaneous innervation in people with diabetic peripheral neuropathy. J Diabetes Complicat. 2012;26(5):424–9.
    1. Hopps E, Canino B, Caimi G. Effects of exercise on inflammation markers in type 2 diabetic subjects. Acta Diabetologia. 2011;48(3):183–9.
    1. Praet S, Van Rooij E, Wijtvliet A, Boonman-de Winter L, Enneking T, Kuipers H, et al. Brisk walking compared with an individualised medical fitness programme for patients with type 2 diabetes: a randomised controlled trial. Diabetologia. 2008;51(5):736–46.
    1. Amini Najafabadi B, Keshavarz S, Asgary S. The 8-week aerobic exercise improves blood sugar، HbA1c and lipid profile in women with type 2 diabetes: A Controlled Randomized Clinical Trial. Jorjani Biomed J. 2020;8(3):44–57.
    1. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C. Physical activity/exercise and type 2 diabetes. Diabetes Care. 2004;27(10):2518–39.
    1. Richerson S, Rosendale K. Does Tai Chi improve plantar sensory ability? A pilot study. Diabetes Technol Ther. 2007;9(3):276–86.
    1. Cavegn EI, Riskowski JL. The effects of Tai Chi on peripheral somatosensation, balance, and fitness in Hispanic older adults with type 2 diabetes: a pilot and feasibility study. Evid Based Complement Alternat Med. 2015;2015:1–9.
    1. Gurfinkel V, Ivanenko YP, Levik YS, Babakova I. Kinesthetic reference for human orthograde posture. Neuroscience. 1995;68(1):229–43.
    1. Singleton JR, Marcus RL, Lessard MK, Jackson JE, Smith AG. Supervised exercise improves cutaneous reinnervation capacity in metabolic syndrome patients. Ann Neurol. 2015;77(1):146–53.
    1. Ahn S, Song R. Effects of tai chi exercise on glucose control, neuropathy scores, balance, and quality of life in patients with type 2 diabetes and neuropathy. J Altern Complement Med. 2012;18(12):1172–8.
    1. Ware JE., Jr SF-36 health survey update. Spine. 2000;25(24):3130–9.
    1. Park SW, Goodpaster BH, Strotmeyer ES, de Rekeneire N, Harris TB, Schwartz AV, et al. Decreased muscle strength and quality in older adults with type 2 diabetes: the health, aging, and body composition study. Diabetes. 2006;55(6):1813–8.
    1. Vincent AM, Feldman EL. New insights into the mechanisms of diabetic neuropathy. Rev Endocrine Metab Disord. 2004;5(3):227–36.
    1. Robinson CC, Barreto RPG, Plentz RDM. Effects of whole-body vibration in individuals with diabetic peripheral neuropathy: a systematic review. J Musculoskel Neuronal Interact. 2018;18(3):382.
    1. Jahantigh Akbari N, Hosseinifar M, Naimi SS, Mikaili S, Rahbar S. The efficacy of physiotherapy interventions in mitigating the symptoms and complications of diabetic peripheral neuropathy: a systematic review. J Diabetes Metabolic Disorders. 2020;19(2):1995–2004.
    1. De Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother. 2009;55(2):129–33.
    1. Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther. 2003;83(8):713–21.
    1. Sartor CD, Hasue RH, Cacciari LP, Butugan MK, Watari R, Pássaro AC, et al. Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial. BMC Musculoskelet Disord. 2014;15(1):1–13.
    1. Hedayati A, Rashidlamir A, Hashemi Javaheri A, Ehsaei MR. The effect of eight weeks of resistance training on static and dynamic balance as well as power of the foot muscles in diabetic women with peripheral neuropathy. SSU J. 2015;23(9):833–843.
    1. Nadi M, Bambaeichi E, Marandi SM. Comparison of the effect of two therapeutic exercises on the inflammatory and physiological conditions and complications of diabetic neuropathy in female patients. Diabetes Metab Syndr Obes. 2019;12:1493.
    1. Kruse RL, LeMaster JW, Madsen RW. Fall and balance outcomes after an intervention to promote leg strength, balance, and walking in people with diabetic peripheral neuropathy: “feet first” randomized controlled trial. Phys Ther. 2010;90(11):1568–79.
    1. Ghazal J, Malik AN, Amjad I. Task-oriented training improves the balance outcome & reducing fall risk in diabetic population. Pakistan J Med Sci. 2016;32(4):983.
    1. Schmid AA, Atler KE, Malcolm MP, Grimm LA, Klinedinst TC, Marchant DR, et al. Yoga improves quality of life and fall risk-factors in a sample of people with chronic pain and type 2 diabetes. Complement Ther Clin Pract. 2018;31:369–73.
    1. Rahbar S, Naimi SS, RezaSoltani A, Rahimi A, Baghban AA, Noori A, et al. Changes in vascular structure in diabetic patients after 8 weeks aerobic physical exercise: a randomized controlled trial. Int J Diabetes Dev Ctries. 2018;38(2):202–8.
    1. Kraiwong R, Vongsirinavarat M, Hiengkaew V, von Heideken Wågert P. Effect of sensory impairment on balance performance and lower limb muscle strength in older adults with type 2 diabetes. Ann Rehabil Med. 2019;43(4):497.
    1. Andreassen C, Jakobsen J, Ringgaard S, Ejskjaer N, Andersen H. Accelerated atrophy of lower leg and foot muscles—a follow-up study of long-term diabetic polyneuropathy using magnetic resonance imaging (MRI) Diabetologia. 2009;52(6):1182–91.
    1. Hung J-W, Liou C-W, Wang P-W, Yeh S-H, Lin L-W, Lo S-K, et al. Effect of 12-week tai chi chuan exercise on peripheral nerve modulation in patients with type 2 diabetes mellitus. J Rehabil Med. 2009;41(11):924–9.
    1. Wang J-S, Lan C, Wong M-K. Tai Chi Chuan training to enhance microcirculatory function in healthy elderly men. Arch Phys Med Rehabil. 2001;82(9):1176–80.

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