scholarly journals TO STUDY "EFFECTIVENESS OF BALANCE TRAINING EXERCISE AND PNF EXERCISE VERSUS ONLY BALANCE TRAINING EXERCISE IN PATIENTS WITH DIABETIC PERIPHERAL NEUROPATHY".

2020 ◽  
pp. 1-3
Author(s):  
Aditya Waje ◽  
Jayashri Kale*
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Balance Control ◽  
Balance Training ◽  
Berg Balance Scale ◽  
Exercise Group ◽  
Exercise Session ◽  
Diabetic Patients ◽  
Exercise Interventions ◽  
Training Exercise

Background- Diabetic peripheral neuropathy (DPN) is a common complication and quality-of-life damaging factor in diabetic patients. Some exercise interventions with balance and muscle strengthening components have been shown to reduce falls it is not known which elements or a combination of elements, of exercise interventions are most effective for improving balance in Diabetic peripheral neuropathy. Objective – To compare the improvement in balance with balance training exercise versus Proprioceptive Neuromuscular Facilitation exercise & balance training exercise Method- Subject was screened using the Michigan Neuropathy Screening Instrument. Forty (40) individuals of both the sexes in the age group of 40-60 years were included & randomly allocated in two groups ( Control & Experiment). Each participant underwent a clinical evaluation on Berg Balance Scale (BBS) at 1st day, 4th week and at 8th week. Exercises were performed daily for 8 weeks under supervision of therapist and advised at home. Each exercise session lasted for 45mins to 60mins. Result – Balance was signicant to improve by balance training exercise group but the combined effect of PNF exercise and balance training appeared to have a greater effect on balance control. Conclusion – PNF exercises should be emphasized along with balance training exercises in the daily exercise regime of diabetic peripheral neuropathy subjects to improve their mobility and functional status.

scholarly journals Computerized Dynamic Posturography in Patients with Diabetic Peripheral Neuropathy and Visual Feedback-Based Balance Training Effects

2014 ◽  
Vol 2 (2) ◽  
pp. 271-276
Author(s):  
Mohieldin M. Ahmed ◽  
Douaa M. Mosalem ◽  
Wafaa A. Tarshouby ◽  
Aziz K. Alfeeli ◽  
Ayyoub B. Baqer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Visual Feedback ◽  
Diabetic Peripheral Neuropathy ◽  
Balance Control ◽  
Balance Training ◽  
Diabetic Patients ◽  
Ratio Score ◽  
Dynamic Posturography ◽  
Computerized Dynamic Posturography

BACKGROUND: Diabetic peripheral neuropathy (DPN) often has reduced stability during standing conditions.AIM: To compare balance control in diabetic patients and normal subjects using computerized dynamic posturography and to assess effect of visual feedback-based balance training in DPN.MATERIALS AND METHODS: A total of 57 patients of type 2 diabetes mellitus and 30 age-matched normal control subjects were recruited. The sensory organization test was done before and after the training program.RESULTS: There was a significant decrease of mean (± SD) of composite equilibrium score and somatosensory ratio score between subgroups of DPN and control healthy group (p < 0.05).  There was a significant increase of mean (± SD) of composite equilibrium score and the somatosensory ratio score after treatment as compared to results before training (p < 0.05) in mild DPN.  Moreover, there were a significant correlation between composite equilibrium score and disease duration before training in the severe DPN (r = 0.368, p < 0.05). CONCLUSIONS: Computerized dynamic posturography is an important quantitative tool in the assessment of posture instability and allows for early disclosure of the failure of the postural control system. Visual feedback-based balance training was shown to be a promising method for fall prevention among early diabetes mellitus with peripheral neuropathy.

scholarly journals Balance and motion coordination parameters can be improved in patients with type 2 diabetes with physical balance training: non-randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Artur Stolarczyk ◽  
Igor Jarzemski ◽  
Bartosz M. Maciąg ◽  
Kuba Radzimowski ◽  
Maciej Świercz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Balance Control ◽  
Balance Training ◽  
Control Group ◽  
Study Group ◽  
Muscle Coordination ◽  
Risk Of Falling ◽  
Increased Risk

Abstract Background Type 2 diabetes (T2D) is a cause of multiple complications, including retinopathy and peripheral neuropathy. These complications are well understood and believed to contribute to gait instability. Poor balance control and increased falling risk have also been reported in people with diabetic peripheral neuropathy (DPN). Patients with DPN have increased risk of falling due to decreased proprioceptive feedback. Effective balance training should improve postural control in patients with DPN. For this purpose further evaluation was conducted and balance training was designed. Methods The goal of our study was to determine values of proprioception, balance, muscle coordination and strength in patients with T2D and analyze whether biofeedback balance training with use of the Biodex Balance System could improve these parameters. To assess the fall risk the general stability index (GSI), the index of frontal-posterior (FPI) and medial–lateral (MLI) stability were evaluated. 37 patients with diagnosed type 2 diabetes mellitus were recruited to this study. Their results were compared with control group consisting of 41 healthy participants who were homogenic to the study group in terms of age and body mass index (BMI). Results There were statistically significant differences between patients with diabetes compared to healthy subjects in GSI (2.79 vs 1.1), FPI (1.66 vs 0.7), MLI (0.88 vs 0.52) and risk of falling (5.18 vs 2.72) p < 0.05. There were also statistically significant changes before and after training in all stability indices (GSI: 2.79 vs 1.26, FPI: 1.66 vs 0.77, MLI: 0.88 vs 0.54 accordingly) p < 0.05 and risk of falling (5.18 vs 3.87) p < 0.05 in the study group who had undergone training with biofeedback. Conclusions This study found that there is a decreased balance and motor coordination and an increased risk of falling in patients with type 2 diabetes. These parameters improved in patients who have undergone training programme with biofeedback. Furthermore, an age-dependent deprivation of static balance was observed along with an increased risk of falling as a result of increasing BMI.

scholarly journals Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review

2021 ◽  
Author(s):  
Koen Andre Horstink ◽  
Lucas Henricus Vincentius van der Woude ◽  
Juha Markus Hijmans
Keyword(s):  
Systematic Review ◽  
Peripheral Neuropathy ◽  
Plantar Pressure ◽  
Diabetic Peripheral Neuropathy ◽  
Balance Control ◽  
Dynamic Balance ◽  
Movement Control ◽  
Future Research ◽  
Static Balance ◽  
Somatosensory Information

AbstractPatients with diabetic peripheral neuropathy (DPN) usually have reduced somatosensory information and altered perception in feet and ankles. Somatosensory information acts as feedback for movement control and loss of somatosensation leads to altered plantar pressure patterns during gait and stance. Offloading devices are used to reduce peak plantar pressure and prevent diabetic foot ulcers. However, offloading devices can unfortunately have negative effects on static and dynamic balance. It is important to investigate these unwanted effects, since patient with DPN already are at high risk of falling and offloading devices could potentially increase this risk. The aim of this systematic review is to investigate the effects of plantar offloading devices used for ulcer prevention on their role in static and dynamic balance control in patients with DPN. PubMed and Embase were systematically searched using relevant search terms. After title selection, abstract selection, and full-text selection only five articles could be included for further analysis. Two articles included static balance measurements, two articles included dynamic balance measurements, and one article included both. Results suggested that static balance control is reduced when rocker bottom shoes and different insole configurations are used, however, toe-only rockers showed less evidence for reduced static balance control. There was no evidence for reduced dynamic balance control in combination with offloading devices. However, these results should be interpreted with care, since the number of studies was very small and the quality of the studies was moderate. Future research should evaluate balance in combination with different offloading devices, so that clinicians subscribing them are more aware of their potential unwanted consequences.

scholarly journals Albumin-Creatinine Ratio is More Diagnostic Sensitive than Cystatin-C in Assessment of Diabetic Peripheral Neuropathy

2018 ◽  
Vol 1 (3) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Cystatin C ◽  
Early Treatment ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Creatinine Ratio ◽  
Serum Cystatin C ◽  
Albumin Creatinine Ratio

Background: Diabetic Peripheral neuropathy is one of the most common cardiovascular complications among diabetes mellitus patients and occurs in more than half of the population of diabetic patients world-wide. It is a common cause of foot ulcer, gangrene and amputation among diabetics. Thus, its prevention or early treatment can improve the quality of life of diabetic patients. In a bid to reduce it, various biochemical markers have been evaluated to enable early treatment and amelioration of diabetic neuropathy among diabetes mellitus patients. Aim: Evaluation of the diagnostic relevance of Cystatin-C versus Albumin-creatinine ratio in assessment of Peripheral neuropathy in diabetic type 2 subjects. Method: 102 type 2 DM subjects (66 females and 36 males) and 100 control subjects of same age range (40 – 80 years) were recruited for this study which includes 51 subjects with peripheral neuropathy and 51 subjects without peripheral neuropathy. Serum Cystatin-C, Microalbuminuria, Urine creatinine and HBA1c were analysed with standard methods. Results: Cystatin-C, Microalbuminuria, Albumin-creatinine ratio and Glycated haemoglobin were significantly elevated (P<0.05) in diabetic subjects compared to the control. Cystatin-C (ng/ml), microalbuminuria (mg/l), albumin creatinine ratio (mg/mmol) and HBA1c (%) is [105.52 ± 45.11; 90.07±20.29; 10.48 ± 4.82; 6.9±1.7] respectively. Microalbuminuria, albumin creatinine ratio showed significant increase (P<0.05) in subjects with peripheral neuropathy compared to those subjects without [92.11± 22.82; 35.70±16.35; 2.61±1.1; 6.38±1.79]. The ROC curve shows that Albumin-creatinine ratio showed significant (P<0.05) sensitivity to peripheral neuropathy [AUC=0.714] while Cystatin-C showed no significant (P<0.05) sensitivity to peripheral neuropathy complication [AUC=0.553]. Conclusion: Cystatin-C was found to be deranged in diabetics. However, Albumin-creatinine ratio showed more diagnostic sensitivity for peripheral neuropathy than Cystatin-C.

scholarly journals Diabetic Peripheral Neuropathy: Epidemiology, Physiopathology, Diagnosis and Treatment

2019 ◽  
Vol 7 (1) ◽  
pp. 35-48
Author(s):  
Nazma Akter
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Clinical Evidence ◽  
Current Treatment ◽  
Diabetic Patients ◽  
First Line ◽  
Diabetic Neuropathic Pain ◽  
Current Treatment Regimen ◽  
Limb Proprioception

Diabetic peripheral neuropathy (DPN) is a common complication of both type 1 and type 2 diabetes. It affects over 90% of the diabetic patients. It is widely accepted that the toxic effects of hyperglycemia play an important role in the development of this complication, but several other hypotheses have been postulated. It is typically characterized by significant deficits in tactile sensitivity, vibration sense, lower-limb proprioception, and kinesthesia. Painful DPN has been shown to be associated with significant reductions in overall quality of life, increased levels of anxiety and depression, sleep impairment, and greater gait variability. DPN is often misdiagnosed and inadequately treated. Clinical recognition of DPN is imperative for allowing timely symptom management to reduce the morbidity associated with this condition. The management of diabetic neuropathic pain consists basically in excluding other causes of painful peripheral neuropathy, improving glycemic control as a prophylactic therapy and using medications to alleviate pain. First line drugs for pain relief include anticonvulsants, such as pregabalin and gabapentin and antidepressants, especially those that act to inhibit the reuptake of serotonin and noradrenaline. In addition, there is experimental and clinical evidence that opioids can be helpful in pain control, mainly if associated with first line drugs. Other agents, including for topical application, such as capsaicin cream and lidocaine patches, have also been proposed to be useful as adjuvant in the control of diabetic neuropathic pain, but the clinical evidence is insufficient to support their use. The purpose of this review is to examine proposed mechanisms of DPN, summarize current treatment regimen. A better understanding of the mechanisms underlying diabetic neuropathic pain will contribute to the search of new therapies. Delta Med Col J. Jan 2019 7(1): 35-48

scholarly journals The Effects of Combined Exercise Training (Resistance-Aerobic) on Serum Kinesin and Physical Function in Type 2 Diabetes Patients with Diabetic Peripheral Neuropathy (Randomized Controlled Trials)

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Seyedeh Hoda Seyedizadeh ◽  
Sadegh Cheragh-Birjandi ◽  
Mohammad Reza Hamedi Nia
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Exercise Training ◽  
Physical Function ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Combined Exercise ◽  
Combined Exercise Training ◽  
Diabetes Patients

Diabetic peripheral neuropathy is one of the most common chronic complications of diabetics which causes nerve damage and muscle strength decrease in patients. This in turn results in imbalance leading to the diabetic patients’ daily activity disparity. The present investigation was conducted to specifically study the effects of combined training (resistance-aerobic) on serum kinesin-1 and physical function in type 2 diabetes patients with diabetic peripheral neuropathy. 24 diabetic neuropathic females were randomly to be selected out and divided into two experimental and control groups. The experimental group received resistance-aerobic training for 3 sessions during eight weeks. The exercise training included resistance exercises with 2-3 sets, 6-7 exercise stations, 8-12 repetitions (reps), and 3-5 minutes of rest in between the exercises, and the aerobic exercises contained 50-65% of heart rate reserve (HRR) for 3 minutes with 30 seconds of rest interval between sets and 5-10 repetitions. Results show that the serum kinesin-1 level and aerobic endurance declined after eight weeks of combined (resistance-aerobic) exercise training, but this decrease was not significant. The upper body strength increased but it was not significant, while the lower body showed a significant strength increase. With regard to the progressive nature of diabetic peripheral neuropathy, it seems that even the little changes resulting from the combined exercise training can be useful. Nevertheless, more research is required in this area.

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

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Erica Shih-Wei Hung ◽  
Shih-Ching Chen ◽  
Fan-Chien Chang ◽  
Yaojung Shiao ◽  
Chih-Wei Peng ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Video Game ◽  
Interactive Video ◽  
Berg Balance Scale ◽  
Diabetic Patients ◽  
Functional Balance ◽  
Positive Effects ◽  
Group A ◽  
Group B ◽  
Interactive Video Game

Purpose. This study evaluated the effects of interactive video game-based (IVGB) exercise on balance in diabetic patients with peripheral neuropathy. Materials and Methods. Twenty-four patients were randomly assigned to two groups (12 participants per group). Group A received IVGB training for the first 6 weeks, with no exercise in the subsequent 6 weeks. Group B had no exercise for the first 6 weeks and then underwent IVGB training in the subsequent 6 weeks. For all participants, the Modified Falls Efficacy Scale (MFES), Time Up and Go (TUG) test, Berg Balance Scale (BBS), and Unipedal Stance Test (UST) were employed at weeks 0, 6, and 12 of the experiment. Results. BBS, right-leg UST, and TUG test scores significantly improved after IVGB intervention, whereas MFES and left-leg UST tended to improve after IVGB intervention. Conclusions. This study revealed that 6-week balance-based exercise training using the IVGB system exerted positive effects on functional balance in patients with diabetic peripheral neuropathy (DPN).

scholarly journals Prognosis of Diabetic Peripheral Neuropathy via Decomposed Digital Volume Pulse from the Fingertip

Entropy ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. 754
Author(s):  
Hai-Cheng Wei ◽  
Wen-Rui Hu ◽  
Na Ta ◽  
Ming-Xia Xiao ◽  
Xiao-Jing Tang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Protective Factor ◽  
Binary Logistic Regression Analysis ◽  
Diabetic Patients ◽  
Frequency Noise ◽  
Baseline Measurement ◽  
Volume Pulse ◽  
Digital Volume Pulse

Diabetic peripheral neuropathy (DPN) is a very common neurological disorder in diabetic patients. This study presents a new percussion-based index for predicting DPN by decomposing digital volume pulse (DVP) signals from the fingertip. In this study, 130 subjects (50 individuals 44 to 89 years of age without diabetes and 80 patients 37 to 86 years of age with type 2 diabetes) were enrolled. After baseline measurement and blood tests, 25 diabetic patients developed DPN within the following five years. After removing high-frequency noise in the original DVP signals, the decomposed DVP signals were used for percussion entropy index (PEIDVP) computation. Effects of risk factors on the incidence of DPN in diabetic patients within five years of follow-up were tested using binary logistic regression analysis, controlling for age, waist circumference, low-density lipoprotein cholesterol, and the new index. Multivariate analysis showed that patients who did not develop DPN in the five-year period had higher PEIDVP values than those with DPN, as determined by logistic regression model (PEIDVP: odds ratio 0.913, 95% CI 0.850 to 0.980). This study shows that PEIDVP can be a major protective factor in relation to the studied binary outcome (i.e., DPN or not in diabetic patients five years after baseline measurement).

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