Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA 92121, USA.
Phys Ther. 2012 Jan;92(1):133-41. doi: 10.2522/ptj.20110048. Epub 2011 Sep 15.
The exercise guidelines for people with diabetes mellitus and peripheral neuropathy (DM+PN) have recently changed to allow moderate-intensity weight-bearing exercise, but there are few reports in the literature describing appropriate weight-bearing exercise for those with DM+PN. This case report describes a successful and safe progressive exercise program for an individual with DM+PN.
The patient was a 76-year-old man with a 30-year history of DM+PN. He participated in a 12-week, moderate-intensity, progressive exercise program (heart rate approximately 75% of maximum heart rate; rate of perceived exertion=11-13; 3 times per week) involving walking on a treadmill, balance exercises, and strengthening exercises for the lower extremities using body weight resistance.
Measurements were taken before and after the 12 weeks of exercise. The patient's Six-Minute Walk Test distance increased from 1,200 to 1,470 ft. His Physical Performance Test score did not change. His Foot and Ankle Ability Measure questionnaire score improved from 89 to 98. Dorsiflexor and plantar-flexor peak torque increased (dorsiflexor peak torque: right side=4.5-4.6 N·m, left side=2.8-3.8 N·m; plantar-flexor peak torque: right side=44.7-62.4 N·m, left side=40.8-56.0 N·m), as did his average daily step count (6,176-8,273 steps/day). Close monitoring of the plantar surface of the feet indicated that the exercise program was well tolerated and there were no adverse events.
This case report describes a moderate-intensity exercise program that was successful in increasing some measures of muscle strength, physical function, and activity without causing injury in an individual with DM+PN.
最近，针对患有糖尿病和周围神经病变（DM+PN）的人群的运动指南已改为允许进行中等强度的负重运动，但文献中很少有关于 DM+PN 患者进行适当负重运动的报道。本病例报告描述了一例 DM+PN 患者成功且安全的渐进式运动方案。
患者为 76 岁男性，患有 DM+PN 病史 30 年。他参加了一项为期 12 周、中等强度、渐进式的运动方案（心率约为最大心率的 75%；感知用力程度=11-13；每周 3 次），包括在跑步机上行走、平衡练习和使用身体自重阻力进行下肢力量练习。
在 12 周的运动前后进行了测量。患者的 6 分钟步行测试距离从 1200 英尺增加到 1470 英尺。他的身体机能测试评分没有变化。他的足部和踝关节能力量表问卷评分从 89 分提高到 98 分。背屈和跖屈峰值扭矩增加（背屈峰值扭矩：右侧=4.5-4.6 N·m，左侧=2.8-3.8 N·m；跖屈峰值扭矩：右侧=44.7-62.4 N·m，左侧=40.8-56.0 N·m），他的平均日常步数也增加了（6176-8273 步/天）。对足部足底表面的密切监测表明，该运动方案耐受良好，无不良事件发生。
本病例报告描述了一项中等强度的运动方案，成功地增加了一些肌肉力量、身体功能和活动水平的测量指标，而不会导致 DM+PN 患者受伤。
