Taveggia Giovanni, Villafañe Jorge H, Vavassori Francesca, Lecchi Cristina, Borboni Alberto, Negrini Stefano
Professor/Physician, Habilita, Istituto Clinico Ospedale di Sarnico, Sarnico, Italy.
Researcher, IRCCS Don Gnocchi Foundation, Milan, Italy.
J Manipulative Physiol Ther. 2014 May;37(4):242-52. doi: 10.1016/j.jmpt.2013.09.007. Epub 2014 Mar 20.
OBJECTIVE: The purpose of this study was to evaluate the effectiveness of the application of analyzing treadmill, muscle strengthening, and balance training compared with a standard care intervention in patients with diabetic neuropathy. METHODS: Twenty-seven patients, 63% female (mean ± standard deviations age, 72 ±9 years), with diabetic neuropathy randomly assigned to receive a multimodal manual treatment approach including analyzing treadmill with feedback focused, isokinetic dynamometric muscle strengthening, and balance retraining on dynamic balance platform or a standard care intervention for activities targeted to improve endurance, manual exercises of muscle strengthening, stretching exercises, gait, and balance exercises (5 weekly over 4 weeks). This study was designed as a double-blind, randomized clinical trial. Measures were assessed at pretreatment, 4 weeks posttreatment, and 2-month follow-up. RESULTS: No important baseline differences were observed between groups. At the end of the treatment period, the experimental group showed a significant increase in gait endurance in a 6-minute walk test, 65.6 m (F[2.0] = 9.636; P = .001). In addition, the 6-minute walk test increased after the intervention, and an even greater difference was found at follow-up (P = .005) for the standard care group. The Functional Independence Measure in both groups increased (P < .01) and continued until the follow-up in the standard care group (P = .003). CONCLUSIONS: The results suggest that the experimental rehabilitation program showed positive effects on the gait endurance after 4 weeks of treatment, whereas it did not produce significant improvements of the gait speed. Both the treatments produced significant improvement of functionalities of the patient.
目的:本研究旨在评估与标准护理干预相比,应用分析性跑步机训练、肌肉强化训练和平衡训练对糖尿病神经病变患者的有效性。 方法:27例糖尿病神经病变患者(63%为女性,平均年龄±标准差为72±9岁)被随机分配接受多模式手法治疗,包括带反馈的分析性跑步机训练、等速测力肌肉强化训练以及在动态平衡平台上进行平衡再训练,或接受针对提高耐力、肌肉强化手法练习、伸展练习、步态和平衡练习的标准护理干预(4周内每周5次)。本研究设计为双盲随机临床试验。在治疗前、治疗后4周和2个月随访时进行测量评估。 结果:两组之间未观察到重要的基线差异。在治疗期结束时,实验组在6分钟步行试验中的步态耐力显著增加,增加了65.6米(F[2.0]=9.636;P=.001)。此外,标准护理组在干预后6分钟步行试验增加,在随访时差异更大(P=.005)。两组的功能独立性测量均增加(P<.01),且在标准护理组随访时仍持续增加(P=.003)。 结论:结果表明,实验性康复计划在治疗4周后对步态耐力产生了积极影响,而对步态速度没有显著改善。两种治疗方法均使患者的功能有显著改善。
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