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Technological Rehabilitation of Distal Sensorimotor Polyneuropathy in Diabetic Patients

21 de março de 2014 atualizado por: Giovanni Taveggia

Technological Rehabilitation of Distal Sensorimotor Polyneuropathy in Diabetic

The investigators evaluated the effectiveness of the application of analysing treadmill, muscle strengthening and balance training compared to a control intervention in patients with diabetic neuropathy.

Visão geral do estudo

Status

Concluído

Condições

Intervenção / Tratamento

Descrição detalhada

Recent studies witnessed how physical exercise may interrupt the devastating decrease of muscle performance in DSP and further experiments are underway to find more exercises for the recovery of motor function impairment. In fact the rehabilitation treatment, that aims at reducing motor disability, preserving gait functions and preventing falling risks, is an interesting therapeutic approach. Literature recommends balance re-training exercises, muscle strengthening, selective stretching and retraining of motor activity.

New technologies produced in the recent decades different devices used in strengthening exercises (electromechanical dynamometers), balance recovery (balance platforms) and gait (analyzing treadmills) have visual feedbacks through which the patients may independently monitor accuracy and intensity of their exercises, being therefore strongly motivated and resulting in a high training intensity. These technologies are often used in rehabilitation of different patients, but are rarely employed for DSP.

The purpose of this case control study was to examine the effectiveness of the application of analysing treadmill, muscle strengthening and balance training compared to a control intervention in patients with diabetic neuropathy.

Tipo de estudo

Intervencional

Inscrição (Antecipado)

36

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

    • Bergamo
      • Sarnico, Bergamo, Itália, 24067
        • Habilita, Ospedale di Sarnico

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos a 85 anos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

Inclusion Criteria:

  • The participants need to have a history of diabetes mellitus type 2, >3 years, (i.e., time from the diagnosis or the beginning of first related signs or symptoms),
  • A diagnosis of Distal Sensorimotor Polyneuropathy associated,
  • Able to walk autonomously, eventually with a aid.

Exclusion Criteria:

  • Scoring less than 5 points on the Functional Independence Measure (FIM) (7) locomotion scale,
  • Presenting articular ankyloses, contractures, spasms with important locomotion effects,
  • Presenting bony instability affecting lower limb functionality (unconsolidated fractures, vertebral instability, severe osteoporosis),
  • In presence of attendant clinicopathological conditions contraindicating the rehabilitation treatment (respiratory insufficiency, cardiac/circulatory failure, osteomyelitis, phlebitis and different other conditions),
  • In presence of cutaneous lesions at lower limbs,
  • Scoring less than 22 points on the Mini Mental State Examination (MMSE),
  • Exhibit important behavioural diseases involving aggressivity or psychotic disorders.
  • Had received prior interventions for Distal Sensorimotor Polyneuropathy.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Dobro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Technological Rehabilitation
Experimental group receives a treatment of: 20 minutes of analyzing treadmill with feedback focused on symmetry and length of stride; 20 minutes of isokinetic dynamometric muscle strengthening of flexor and extensor muscles of tibiotarsal joint; 20 minutes of balance retraining on dynamic balance platform. Each patient receives 20 sessions over a period of 4 weeks (5 sessions per week).

The length of stride of reference used during the exercise is personalized and depends on the height of patients. Each patient carries out the feedback for 20 minutes with the aim of generating the most symmetric and regular gait.

Patients, with the dynamometer, work on strengthening of flexor and extensor muscles with ankle speeds at 90°/sec and 120°/sec. The strengthening technique was performed twice for 10 minutes each time with a 1 minute rest between sets.

The session ends with a 20-minute feedback on dynamic balance platform by carrying out exercises in which they need to reach randomly appearing targets. Subjects begin with 12 minutes the first 4 sessions, progress to 16 minutes the next 2 sessions, then 18' (2 sessions), and finally 20', if able, during the last 4 sessions.

Outros nomes:
  • Dynamometric isokinetic device: Biodex System 4,
  • Balance device: Biodex Balance System SD,
  • Analyzing treadmill: Biodex Gait Trainer 3.
Comparador Ativo: Control Rehabilitation
Control group receives the same number of treatment sessions of same duration as those in the experimental group: activities targeted to improve the endurance (instead of analyzing treadmill ), manual exercises of lower limb muscle strengthening, stretching exercises (instead of dynamometer), gait retraining on the floor for 20 minutes and static and dynamic balance exercises in upright position (instead of dynamic balance platform).
When needed, more than on e therapist are employed in the intervention for safety reasons.
Outros nomes:
  • Reabilitação manual com o terapeuta.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Change from Baseline of 6-minute walk test
Prazo: 1 day after the treatment

All evaluation procedures are performed by the same examiner who was blinded to the aims of the study and to which group the participants are allocated. The 6-minute walk test (6MWT) is used to assess endurance.

The 6MWT quantifies functional mobility based on the distance in meters traveled in six minutes. This outcome is a measure of endurance and is particularly significant to evaluate the possibility to perform continuative tasks, that are particularly important for the rehabilitation of diabetic patients and are relevant for an autonomous life. Subjects are instructed to walk at a comfortable speed and subjects neurological are able to use assistive devices.

1 day after the treatment
Change from Baseline of 10-metres walk test
Prazo: 1 day after the treatment

All evaluation procedures are performed by the same examiner who was blinded to the aims of the study and to which group the participants are allocated. The 10-metres walking test is used to assess gait speed.

The speed is quantified with the 10-metres walk test (TWT) over the ground. The gait speed measurement is performed over the middle 6 meters of the TWT and patients are asked to walk at their comfortable speed. Subjects are instructed to walk at a comfortable speed and subjects neurological are able to use assistive devices.

1 day after the treatment

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Followup change from Baseline of 6-minute walk test
Prazo: 30 days after the treatment

All evaluation procedures are performed by the same examiner who was blinded to the aims of the study and to which group the participants are allocated. The 6-minute walk test (6MWT) is used to assess endurance.

The 6MWT quantifies functional mobility based on the distance in meters traveled in six minutes. This outcome is a measure of endurance and is particularly significant to evaluate the possibility to perform continuative tasks, that are particularly important for the rehabilitation of diabetic patients and are relevant for an autonomous life. Subjects are instructed to walk at a comfortable speed and subjects neurological are able to use assistive devices.

30 days after the treatment
Followup change from Baseline of 10-metres walk test
Prazo: 30 days after the treatment

All evaluation procedures are performed by the same examiner who was blinded to the aims of the study and to which group the participants are allocated. The 10-metres walking test is used to assess gait speed.

The speed is quantified with the 10-metres walk test (TWT) over the ground. The gait speed measurement is performed over the middle 6 meters of the TWT and patients are asked to walk at their comfortable speed. Subjects are instructed to walk at a comfortable speed and subjects neurological are able to use assistive devices.

30 days after the treatment
Change from Baseline of the Functional Independence Measure (FIM)
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the Tinetti scale
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the Resting Energy Expenditure (REE)
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the Respiratory Rate (RR)
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the Heart Rate (HR)
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the oxygen saturation (SpO2)
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the maximal oxygen consumption (VO2 max)
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the expired minute volume (Ve)
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the fraction of expired air that is oxygen (FeO2)
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the Systolic Blood Pressure (SBP)
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the Diastolic Blood Pressure (DBP)
Prazo: 1 day after the treatment
1 day after the treatment
Change from Baseline of the Glycated Hemoglobin (HbA1c)
Prazo: 1 day after the treatment
1 day after the treatment
Followup change from Baseline of the Functional Independence Measure (FIM)
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the Tinetti scale
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the Resting Energy Expenditure (REE)
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the Respiratory Rate (RR)
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the Heart Rate (HR)
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the oxygen saturation (SpO2)
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the maximal oxygen consumption (VO2 max)
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the expired minute volume (Ve)
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the fraction of expired air that is oxygen (FeO2)
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the Systolic Blood Pressure (SBP)
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the Diastolic Blood Pressure (DBP)
Prazo: 30 days after the treatment
30 days after the treatment
Followup change from Baseline of the Glycated Hemoglobin (HbA1c)
Prazo: 30 days after the treatment
30 days after the treatment

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Investigadores

  • Investigador principal: Giovanni Taveggia, MD, Habilita, Ospedale di Sarnico

Publicações e links úteis

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Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de setembro de 2013

Conclusão Primária (Real)

1 de novembro de 2013

Conclusão do estudo (Real)

1 de novembro de 2013

Datas de inscrição no estudo

Enviado pela primeira vez

14 de agosto de 2013

Enviado pela primeira vez que atendeu aos critérios de CQ

17 de agosto de 2013

Primeira postagem (Estimativa)

21 de agosto de 2013

Atualizações de registro de estudo

Última Atualização Postada (Estimativa)

24 de março de 2014

Última atualização enviada que atendeu aos critérios de controle de qualidade

21 de março de 2014

Última verificação

1 de março de 2014

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Outros números de identificação do estudo

  • Habilita-RAR-02
  • 201206180007491711110 (Outro identificador: Bioethic board)

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