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运动对糖尿病患者神经病变的干预效果:一项系统评价与Meta分析

Interventional effects of exercise on neuropathy in patients with diabetes: a systematic review with meta-analysis.

作者信息

Nguyen Vanphuc, Dinh Quangngoc, Yu Fen, Jia Shuqi, Wang Xing

机构信息

Bac Ninh Sport Univesity, Bac Ninh, Vietnam.

Institute of Sport Science and Technology, Bac Ninh Sport Univesity, Bac Ninh, Vietnam.

出版信息

BMC Sports Sci Med Rehabil. 2025 Apr 14;17(1):82. doi: 10.1186/s13102-025-01136-z.

Abstract

OBJECTIVE

This study aims to systematically evaluate the effects of exercise interventions on neurological dysfunction in diabetic patients, addressing inconsistencies in existing research. It seeks to clarify the impact of different exercise parameters and patient characteristics on nerve function improvements, providing evidence for optimized intervention strategies.

METHODS

A search was conducted using PubMed, Web of Science, The Cochrane Library, and Embase databases for randomized controlled trials related to exercise interventions for neurological dysfunction in diabetic patients. The quality of the included studies was assessed according to the Cochrane Handbook for Systematic Reviews. The study utilized RevMan 5.3 to determine effect sizes and assess heterogeneity. Stata 17.0 was employed to evaluate publication bias in the included studies.

RESULTS

The analysis incorporated 9 randomized controlled trials. The meta-analysis demonstrated that exercise leads to improvements in neurological dysfunction among diabetes patients (SMD = 0.61). Subgroup analysis revealed that an 8-week exercise regimen with moderate intensity was particularly effective in enhancing neurological function (SMD = 1.82, 1.58). Improvements were more pronounced in lower limb nerve conduction velocity (SMD = 0.60), peroneal nerve conduction velocity (SMD = 0.86), and sensory nerve conduction velocity (SMD = 0.59). Patients with a disease duration of 5 years or less showed significant improvement (SMD = 0.62).

CONCLUSION

Exercise effectively improves neurological dysfunction in diabetic patients, with an 8-week, moderate-intensity program showing the greatest benefits, particularly in lower limb and sensory nerve conduction velocity. These findings offer evidence-based guidance for clinical intervention and future research.

REGISTRATION AND PROPOSAL

This study was registered with PROSPEO under No. CRD42024586981; the proposal is available at www.crd.york.ac.uk .

摘要

目的

本研究旨在系统评估运动干预对糖尿病患者神经功能障碍的影响,解决现有研究中的不一致性。它试图阐明不同运动参数和患者特征对神经功能改善的影响,为优化干预策略提供证据。

方法

使用PubMed、Web of Science、Cochrane图书馆和Embase数据库搜索与糖尿病患者神经功能障碍运动干预相关的随机对照试验。根据Cochrane系统评价手册评估纳入研究的质量。本研究利用RevMan 5.3确定效应大小并评估异质性。使用Stata 17.0评估纳入研究中的发表偏倚。

结果

分析纳入了9项随机对照试验。荟萃分析表明,运动可改善糖尿病患者的神经功能障碍(标准化均数差[SMD]=0.61)。亚组分析显示,8周的中等强度运动方案在增强神经功能方面特别有效(SMD=1.82,1.58)。下肢神经传导速度(SMD=0.60)、腓总神经传导速度(SMD=0.86)和感觉神经传导速度(SMD=0.59)的改善更为明显。病程在5年或以下的患者有显著改善(SMD=0.62)。

结论

运动可有效改善糖尿病患者的神经功能障碍,8周的中等强度运动方案显示出最大益处,尤其是在下肢和感觉神经传导速度方面。这些发现为临床干预和未来研究提供了循证指导。

注册与方案

本研究已在PROSPERO注册,注册号为CRD42024586981;方案可在www.crd.york.ac.uk上获取。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f85e/11995640/12f38cfda6f6/13102_2025_1136_Fig1_HTML.jpg

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