Physical exercise in patients with diabetic neuropathy: systematic review and meta-analysis of randomized clinical trials

Authors

  • Caren Tais Piccoli Maronesi Universidade Regional Integrada
  • Sheila Cristina Cecagno-Zanini Universidade de Passo Fundo (UPF) – Passo Fundo (RS), Brasil
  • Luma Zanatta de Oliveira Universidade de Passo Fundo (UPF) – Passo Fundo (RS), Brasil
  • Suzane Stella Bavaresco Universidade de Passo Fundo (UPF) – Passo Fundo (RS), Brasil
  • Camila Pereira Leguisamo Universidade de Passo Fundo; programa de pós-graduação em Envelhecimento Humano

DOI:

https://doi.org/10.1590/1809-2950/14649323022016

Abstract

The aim of this study was to systematically review the effects of treatment with aerobic, resistance or combined (resistance/aerobic/balance) exercises in the balance, muscular strength and glycemic index of patients with diabetic neuropathy. Searches were conducted in the electronic databases: MEDLINE (via PubMed), COCHRANE CENTRAL, LILACS (via Bireme) and PEDro of randomized clinical trials, which conducted aerobic, resistance or combined (resistance/aerobic/balance) exercises compared with the control group in individuals with diabetic neuropathy. The outcomes considered were: balance evaluated from ABC scale and glycemic index at fasting and at postprandial. Out of 389 studies, five were included, with a total of 292 individuals. We observed that the combined exercise (resistance/balance) compared with the control demonstrated significant improvement of balance (8; 95%CI). 1.12, 14.88; I2 = 0%). Two out of the five included studies evaluated the muscular strength of LL (Lower Limbs) (n=116), both studies with combined exercises (resistance/balance) versus control, but we could not conduct the meta-analysis of these studies as muscle strength was evaluated in different ways. Only one article evaluated the postprandial and fasting glycemic index (n = 87), which precluded meta-analysis. In this study, the postprandial and fasting glycemic index showed no significant difference when compared the two groups. The data analyzed in this review demonstrated that the balance in individuals with diabetic neuropathy improved with combined exercise.

Downloads

Download data is not yet available.

References

Santos AA, Bertato FT, Montebelo MIL, Guirro ECO. Efeito

do treinamento proprioceptivo em mulheres diabéticas. Rev

Bras Fisioter. 2008;12(3):183-7.

Busui RP. Cardiac autonomic neuropathy in diabetes.

Diabetes Care. 2010;33(2):434-41.

Hung JW, Liou CW, Wang PW, Yeh SH, Lin LH, Lo SK, 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.

Duarte CK, Almeida JC, Merker AJS, Brauer FO, Rodrigues

TC. Nível de atividade física e exercício físico em pacientes

com diabete mellitus. Rev Assoc Med Bras. 2012;58(2):215-21.

White CM, Pritchard J, Turner-Stokes L. Exercise for people

with peripheral neuropathy. Cochrane Database Syst Rev.

;6:1-43.

Higgins JPT, Green S. Cochrane handbook for systematic

reviews of interventions. 5ª ed. Chichester: John Wiley &

Sons, 2011.

Moher D, Liberati A, Tetzlaff J, Altman DG. Reprint-Preferred

reporting items for systematic reviews and meta-analyses:

The prisma statement. Phys Ther. 2009;89(9):873-80.

Richardson JK, Sandman D, Vela V. A focused exercise

regimen improves clinical measures of balance in patients

with peripheral neuropathy. Arch Phys Med Rehabil.

;82(2):205-9.

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(137):137-50.

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.

Lee K, Lee S, Song C. Whole-body vibration training improves

balance, muscle strength, and glycosylated hemoglobin in

elderly patients with diabetic neuropathy. Tohoku J Exp Med.

;231(4):305-14.

Dixit S, Maiya AG, Shastry B. A. Effect of aerobic exercise

on peripheral nerve functions of population with diabetic

peripheral neuropathy in type 2 diabetes: A single blind,

parallel group randomized controlled trial. J Diabetes

Complications. 2014;28(3):332-9.

Downloads

Published

2016-06-06

Issue

Vol. 23 No. 2 (2016)

Section

Revisão Sistemática

License

Copyright (c) 2016 Fisioterapia e Pesquisa

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

How to Cite

Physical exercise in patients with diabetic neuropathy: systematic review and meta-analysis of randomized clinical trials . (2016). Fisioterapia E Pesquisa, 23(2), 216-223. https://doi.org/10.1590/1809-2950/14649323022016