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糖尿病患者远端感觉运动性多发性神经病的多模式治疗:一项随机临床试验。

Multimodal treatment of distal sensorimotor polyneuropathy in diabetic patients: a randomized clinical trial.

作者信息

Taveggia Giovanni, Villafañe Jorge H, Vavassori Francesca, Lecchi Cristina, Borboni Alberto, Negrini Stefano

机构信息

Professor/Physician, Habilita, Istituto Clinico Ospedale di Sarnico, Sarnico, Italy.

Researcher, IRCCS Don Gnocchi Foundation, Milan, Italy.

出版信息

J Manipulative Physiol Ther. 2014 May;37(4):242-52. doi: 10.1016/j.jmpt.2013.09.007. Epub 2014 Mar 20.


DOI:10.1016/j.jmpt.2013.09.007
PMID:24656867
Abstract

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.

摘要

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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引用本文的文献

[1]
A Systematic Review of the Effect of Physical Rehabilitation on Balance in People with Diabetic Peripheral Neuropathy Who are at Risk of Falling.

Clin Interv Aging. 2024

[2]
Therapeutic Interventions to Improve Static Balance in Type 2 DiabetesMellitus: A Systematic Review and Meta-Analysis.

Curr Diabetes Rev. 2024

[3]
Effectiveness of Virtual Reality and Feedback to Improve Gait and Balance in Patients with Diabetic Peripheral Neuropathies: Systematic Review and Meta-Analysis.

Healthcare (Basel). 2023-11-24

[4]
Foot-ankle therapeutic exercise program can improve gait speed in people with diabetic neuropathy: a randomized controlled trial.

Sci Rep. 2022-5-9

[5]
The Application of Exercise Training for Diabetic Peripheral Neuropathy.

J Clin Med. 2021-10-28

[6]
Efficacy of exercise on balance, fear of falling, and risk of falls in patients with diabetic peripheral neuropathy: a systematic review and meta-analysis.

Arch Endocrinol Metab. 2021-11-1

[7]
Effectiveness of Exercise Therapy on Gait Function in Diabetic Peripheral Neuropathy Patients: A Systematic Review of Randomized Controlled Trials.

Diabetes Metab Syndr Obes. 2020-8-5

[8]
Physical activity and dietary interventions in diabetic neuropathy: a systematic review.

Clin Auton Res. 2019-5-10

[9]
Effects of Interactive Video Game-Based Exercise on Balance in Diabetic Patients with Peripheral Neuropathy: An Open-Level, Crossover Pilot Study.

Evid Based Complement Alternat Med. 2019-3-6

[10]
Protocol for evaluating the effects of a foot-ankle therapeutic exercise program on daily activity, foot-ankle functionality, and biomechanics in people with diabetic polyneuropathy: a randomized controlled trial.

BMC Musculoskelet Disord. 2018-11-14

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