Strength, balance training benefits people with diabetic peripheral neuropathy
medwireNews: Short-term structured strength and balance training does not improve quality of life (QoL) in patients with type 2 diabetes-related peripheral neuropathy, but may increase functional status and balance confidence, research shows.
For their study, Kavita Venkataraman (National University of Singapore and National University Health System) and co-investigators randomly assigned 134 patients (mean age 62 years, 56% women) to receive 2 months of weekly home-based strength and balance training sessions (n=67) or standard medical care (n=67).
The training sessions were led by a physiotherapist and included a range of exercises for motion, muscle strengthening, endurance, and improving static and dynamic balance. In addition, the participants were encouraged to perform the same exercises on their own at least three more times per week.
At 6 months, there was no significant difference between the groups in health-related (HR)QoL as measured by both the physical component summary score of the SF-36v2 instrument and the EQ-5D-5L index score.
The intervention was, however, associated with significantly greater improvements in the body pain domain of SF-36v2 (mean difference [MD]=5.14 points) relative to usual care.
Patients who took part in the training sessions also experienced “statistically significant and clinically meaningful” improvements in functional status at 6 months compared with those receiving usual care.
These included improvements in timed up-and-go test performance (MD=−1.14 seconds), five times sit-to-stand test performance (MD=−1.31 seconds), ankle muscle strength (MD=4.18 N), ankle range of motion (MD=3.17º), knee range of motion (MD=6.82º), and activities-specific balance confidence score (MD=6.17%).
However, Venkataraman and colleagues comment that the “magnitude of improvement in functional status did not appear to be sufficiently large to impact overall HRQoL.”
They conclude in Diabetologia that “[l]onger-term and more intensive interventions may be needed to influence HRQoL in these individuals.”
Nonetheless, they add that “an intervention of this nature may help to preserve functional status, improve balance confidence and reduce the likelihood of falls and injuries in individuals with [diabetic peripheral neuropathy].”
By Laura Cowen
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