The effects of combined physical procedures on the functional status of patients with diabetic polyneuropathy

  • Vesna Grbović University Clinical Center Kragujevac, Center for Physical Medicine and Rehabilitation, Clinic for Internal Medicine, Kragujevac, Serbia
  • Svetlana Djukić University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
  • Srdjan Stefanović University of Kragujevac, Faculty of Medical Sciences, Department of Clinical Pharmacy, Kragujevac, Serbia
  • Nataša Zdravković-Petrović University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
  • Stefan Simović University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
  • Aleksandra Jurisić-Škevin University Clinical Center Kragujevac, Center for Physical Medicine and Rehabilitation, Clinic for Internal Medicine, Kragujevac, Serbia
Keywords: ankle joint, diabetic neuropathies, muscle strength, physical therapy modalities, range of motion, articular, thiotic acid

Abstract


Background/Aim. Diabetic polyneuropathy is a common chronic complication in patients with diabetes mellitus. The aim of this study was to determine the importance of applied physical procedures on the functional status of diabetic polyneuropathy patients compared to the group of respondents treated by alpha-lipoic acid. Methods. Sixty subjects were divided into two groups: group A – diabetic polyneuropathy patients treated with physical procedures, and group B – diabetic polyneuropathy patients treated with alpha-lipoic acid. The study has lasted for three diagnostic and therapeutic cycles, each lasting for 16 days with a time between cycles of 6 weeks. Results. Manual muscle test, range of motion, Michigan Neuropathy Screening Instrument, and Berg balance scale values showed statistically significant improvement at the end of testing group A respondents, while no improvement was shown in group B respondents. Conclusion. The application of the combined physical procedures shows clear benefits for the improvement of muscle strength and mobility of the ankle joint in respondents with diabetic polyneuropathy.

References

Boulton AJ. Management of diabetic peripheral neuropathy. Clin Diabetes 2005; 23(1): 9–15.

Serbian Diabetes Registry. Incidence and Mortality of Diabe-tes in Serbia. Report No 5. Belgrade: Institute of Public Health of Serbia “Dr. Milan Jovanovic Batut”; 2010.

Armstrong DG, Lavery LA. Diabetic foot ulcers: prevention, diagnosis and classification. Am Fam Physician 1998; 57(6):1325‒32, 1337‒8.

Morrison S, Colberg SR, Parson HK, Vinik AI. Relation between risk of falling and postural sway complexity in diabetes. Gait Posture 2012; 35(4): 662–8.

Cavanagh P, Derr JA, Ulbrecht JS, Maser RE, Orchard TJ. Problems with gait and posture in neuropathic patients with insulin-dependent diabetes mellitus. Diabet Med 1992; 9(5): 469–74.

Sinacore DR, Bohnert KL, Hastings MK, Johnson JE. Midfoot kinetics characterize structural polymorphism in diabetic foot disease. Clin Biomech 2008; 23(5): 653‒61.

Zimny S, Schatz H, Pfohl M. The role of limited joint mobility in diabetic patients with an at-risk foot. Diabetes Care 2004; 27(4): 942‒6.

Andersen H, Poulsen PL, Mogensen CE, Jakobsen J. Isokinetic muscle strength in long-term IDDM patients in relation to diabetic complications. Diabetes 1996; 45(4): 440‒5.

Andersen H, Nielsen S, Mogensem CE, Jakobsen J. Muscle strength in type 2 diabetes. Diabetes 2004; 53(6): 1543‒8.

Grbovic V, Jurisic-Skevin A, Djukic S, Stefanović S, Nurkovic J. Comparative analysis of the effects combined physical proce-dures and alpha-lipoic acid on the electroneurographic param-eters of patients with distal sensorimotor diabetic polyneurop-athy. J Phys Ther Sci 2016; 28(2): 432‒7.

Grbovic V, Stefanovic S, Djukic S, Nurkovic J, Zdravkovic-Petrovic N, Parezanovic-Ilic K, et al. The effects of the physical proce-dures in patients with diabetic neuropathy. Vojnosanit Pregl 2019; 76(8): 787‒94.

Feldman EL, Stevens MJ, Thomas PK, Brown MB, Canal N, Greene DA. A practical two-step quantitative clinical and elec-trophysiological assessment for the diagnosis and staging of di-abetic neuropathy. Diabetes Care 1994; 17(11): 1281–9.

Kendall FP, McCreary EK, Provance PG. Muscles: Testing and Function. Baltimore, MD: Williams & Wilkins; 1993.

Luttgens K, Hamilton N. Kinesiology: Scientific basis of human motion. 9th ed. Madison, WI: Brown&Benchman; 1997.

Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Pub-lic Health 1992; 83(Suppl 2): S7‒11.

Sartor DS, Hasue RH, Cacciari LP, Butugan MK, Watari R, Pássaro AC, et al. Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial. BMC Musculoskeletal Disord 2014; 15: 137.

Kluding PM, Pasnoor M, Singh R, Jernigan S, Farmer K, Rucker J, et al. The Effect of Exercise on Neuropathic Symptoms, Nerve Function, and Cutaneous Innervation in People with Diabetic Peripheral Neuropathy. J Diabetes Complications. 2012; 26(5): 424–9.

Bosi E, Bax G, Scionti L, Spallone V, Tesfaye S, Valensi P, et al. Frequency-modulated electromagnetic neural stimulation (FREMS) as a treatment for symptomatic diabetic neuropa-thy: results from a double-blind, randomized, multicentre, long-term, placebo-controlled clinical trial. Diabetologia 2013; 56(3): 467‒75.

Liu F, Zhang Y, Yang M, Liu B, Shen YD, Jia WP, et al. Cura-tive effect of alpha-lipoic acid on peripheral neuropathy in type 2 diabetes: a clinical study. Zhonghua Yi Xue Za Zhi 2007; 87(38): 2706‒9. (Chinese)

Song CH, Petrofsky JS, Lee SW, Lee KJ, Yim JE. Effects of an exercise program on balance and trunk proprioception in older adults with diabetic neuropathies. Diabetes Technol Ther 2011; 13(8): 803‒11.

Bokan V. Muscle weakness and other late complications dia-betic polyneuropathy. Acta Clin Croat 2011; 50(3): 351‒5.

Francia P, Anichini R, De Bellis A, Seghieri G, Lazzeri R, Pater-nostro F, et al. Diabetic foot prevention: the role of exercise therapy in the treatment of limited joint mobility, muscle weakness and reduced gait speed. Ital J Anat Embryol 2015; 120(1): 21‒32.

Published
2022/07/13
Section
Original Paper