Effect of three-week exercise program on muscle strength and joint mobility in patients with diabetic polyneuropathy: Randomized controlled trial.

IF 4.2 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2024-12-15 DOI:10.4239/wjd.v15.i12.2311

Snježana Novaković-Bursać, Goran Talić, Nataša Tomić, Ranko Škrbić, Ivan Soldatovic

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引用次数: 0

Abstract

Background: Limited joint mobility is the proven risk factor for diabetic foot ulceration when present in the subtalar and first metatarsophalangeal joints. Evidence shows that a foot-related exercise program, combined with a health-promoting program, can improve the signs and symptoms of diabetic polyneuropathy, enhance gait, restore mobility in the foot and ankle joints, redistribute pressure while walking, and increase foot strength and function. As a result, these exercise programs can help mitigate the risk factors for diabetic foot ulceration.

Aim: To determine the effect of supervised stretching, strengthening, functional and walking exercises on joint mobility and muscle strength in patients with diabetic polyneuropathy.

Methods: This was a randomized controlled trial conducted in a tertiary hospital. The study included 82 participants allocated into the intervention group (alpha-lipoic acid and exercise on 15 consecutive therapeutic days, n = 42) and control group (alpha lipoic acid only, n = 40). Muscle strength included dorsal and plantar flexors dynamometry and strength score, while range of motion included ankle, subtalar and first metatarsophalangeal joint goniometry.

Results: Change of motion range was significantly higher in the intervention group compared to the control group regarding ankle joint on day 15 (9.9 ± 7.2 vs 0.1 ± 3.3; P = 0.006) and month 6 (2.8 ± 7.3 vs -0.9 ± 4.1; P < 0.001), subtalar joint on day 15 (7.5 ± 5.1 vs -0.25 ± 2.25; P < 0.001) and month 6 (3.9 ± 6.4 vs -0.13 ± 3.49; P < 0.001). Change in dorsal flexors was significantly higher in the intervention group compared to the control group on day 15 (2.62 ± 1.69 vs 0.10 ± 1.35; P < 0.001) and month 6 (0.66 ± 2.38 vs -0.75 ± 1.94; P = 0.004) as well as plantar flexors on day 15 (3.3 ± 1.6 vs 0.3 ± 1.5; P < 0.001) and month 6 (1.8 ± 2.2 vs -0.9 ± 2.1; P < 0.001). Muscle strength score change was significantly lower in the intervention group compared to the control group on day 15 (-1.45 ± 1.42 vs -0.03 ± 0.16; P < 0.001) and month 6 (-1.17 ± 1.53 vs 0.20 ± 0.56; P < 0.001).

Conclusion: Exercise in combination with alpha-lipoic acid can improve joint mobility, as well as strength of the foot and lower leg muscles in patients with diabetic polyneuropathy.

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为期三周的锻炼计划对糖尿病多发性神经病变患者肌肉力量和关节活动度的影响：随机对照试验

背景：关节活动受限是糖尿病足溃疡发生在距下和第一跖趾关节的危险因素。有证据表明，与足部相关的锻炼计划，结合健康促进计划，可以改善糖尿病多发性神经病变的体征和症状，改善步态，恢复足部和踝关节的活动能力，重新分配行走时的压力，并增加足部的力量和功能。因此，这些锻炼计划可以帮助减轻糖尿病足溃疡的风险因素。目的：探讨有监督的拉伸、强化、功能和步行运动对糖尿病多发神经病患者关节活动能力和肌力的影响。方法：在某三级医院进行随机对照试验。研究纳入82名参与者，分为干预组（α -硫辛酸和连续15天运动治疗组，n = 42）和对照组（α -硫辛酸组，n = 40）。肌肉力量包括背屈肌和足底屈肌的动力测量和力量评分，而运动范围包括踝关节、距下关节和第一跖指关节的角度测量。结果：干预组第15天踝关节活动度变化明显高于对照组（9.9±7.2 vs 0.1±3.3）；P = 0.006)和第6个月(2.8±7.3 vs -0.9±4.1；P < 0.001)，距下关节在第15天(7.5±5.1 vs -0.25±2.25；P < 0.001)和第6个月(3.9±6.4 vs -0.13±3.49；P < 0.001)。干预组在第15天的背屈肌变化明显高于对照组(2.62±1.69 vs 0.10±1.35；P < 0.001)和第6个月(0.66±2.38 vs -0.75±1.94；P = 0.004)和第15天的足底屈肌(3.3±1.6 vs 0.3±1.5；P < 0.001)和第6个月(1.8±2.2 vs -0.9±2.1；P < 0.001)。干预组第15天肌力评分变化明显低于对照组(-1.45±1.42 vs -0.03±0.16；P < 0.001)和第6个月(-1.17±1.53 vs 0.20±0.56；P < 0.001)。结论：运动联合α -硫辛酸可改善糖尿病多发神经病变患者的关节活动度，以及足部和小腿肌肉的力量。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.