Køhler Esben, Dalgas Ulrik, Buhl Christian Selmer, Brincks John
Department of Public Health, Section of Sports Science, Aarhus University, Aarhus, Denmark.
Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
Physiother Theory Pract. 2025 May;41(5):1083-1094. doi: 10.1080/09593985.2024.2391823. Epub 2024 Aug 20.
Diabetic Peripheral Neuropathy (DPN) impairs balance due to sensory loss, proprioceptive deficits, muscle weakness, altered gait, and delayed reflexes. Targeted aerobic and balance training seem promising to mitigate these issues. However, the exact content of a recommended training regime is yet to be determined.
To delineate and synthesise balance training content and efficacy for people with DPN.
The literature search was conducted on PubMed and Embase in accordance with the PRISMA-checklist. Last search was performed on April 29, 2024. Inclusion criteria were established using the PICO-framework. Methodological quality was assessed using the TESTEX Scale. Meta-analyses were exclusively applied to studies featuring a passive control group.
A total of 2007 articles were identified. Twelve studies were included in the qualitative synthesis. Seven studies were included in the meta-analyses. Two studies were of high quality. Most studies reported the frequency, session time, duration, and setting of balance training, while none reported the intensity. The meta-analyses showed a standardized mean difference in favor of balance training compared to passive control for One-Legged Stance (openeyes) (0.89[0.5,1.28]), One-Legged Stance (closed eyes) (1.48[0.36, 2.60]), Postural sway (-0.71[-1.04, -0,37]), Timed Up and Go(-0.94[-1.78, -0.10]), and Berg Balance Scale (2.26[0.48, 4.05]), respectively.
Studies are few and generally of low methodological quality. The content of balance training interventions is minimally described, especially concerning the applied intensity. However, balance training does seem to improve balance outcomes in people with DPN, but given the methodological limitations, interpretation must be cautious.
糖尿病周围神经病变（DPN）会因感觉丧失、本体感觉缺陷、肌肉无力、步态改变和反射延迟而损害平衡能力。有针对性的有氧运动和平衡训练似乎有望缓解这些问题。然而，推荐训练方案的确切内容尚未确定。
阐述并综合DPN患者的平衡训练内容及效果。
按照PRISMA清单在PubMed和Embase上进行文献检索。最后一次检索于2024年4月29日进行。使用PICO框架确定纳入标准。使用TESTEX量表评估方法学质量。荟萃分析仅应用于设有被动对照组的研究。
共识别出2007篇文章。12项研究纳入定性综合分析。7项研究纳入荟萃分析。2项研究质量较高。大多数研究报告了平衡训练的频率、每次训练时间、持续时间和训练环境，而无一报告强度。荟萃分析显示，与被动对照组相比，平衡训练在单腿站立（睁眼）（0.89[0.5,1.28]）、单腿站立（闭眼）（1.48[0.36, 2.60]）、姿势摆动（-0.71[-1.04, -0.37]）、计时起立行走（-0.94[-1.78, -0.10]）和伯格平衡量表（2.26[0.48, 4.05]）方面的标准化均数差值均有利于平衡训练。
研究数量少且方法学质量普遍较低。平衡训练干预的内容描述极少，尤其是关于所应用的强度。然而，平衡训练似乎确实能改善DPN患者的平衡结果，但鉴于方法学上的局限性，解释时必须谨慎。
