Exercises for diabetic peripheral neuropathy remain controversial, especially with regard to recommended precautions and weightbearing exercises for individuals. We aimed to investigate the effect of 8 weeks of simple hand, finger, and foot exercises in patients with diabetic peripheral neuropathy. After randomization, exercise (n = 51) and control (n = 53) groups received usual care and diabetic foot care education; only the exercise group performed exercises. Primary outcomes, including activities of daily living (assessed using the Patient Neurotoxicity Questionnaire), neuropathy severity (monofilament and vibration test), and pain (behavioral rating scale and Visual Analog Scale), and secondary outcomes, including physical function of the hand and foot (grip, pinch, finger counting time, and Timed Up and Go tests), were assessed at baseline, after the 8‐week intervention, and at the 16‐week follow‐up. The exercise group showed significantly stronger improvements in motor score and specific activities of daily living, such as climbing stairs and performing work or chores. Our exercises can be used to improve limb function in patients with diabetic neuropathy.

SUMMARY1. The intramural pelvic nerves of the dog colon were studied morphologically and electrophysiologically.2. These nerves emanate from the pelvic plexus, and ascend between the muscle layers along 57-5 % ofthe colon's length. Many thin branches connect with Auerbach's plexus.3. Most of the nerves responded bilaterally with compound action potentials of Ad and C fibres to stimulation of the sacral dorsal roots, and with those of C fibres to stimulation of the ventral roots. Mean conduction velocities of the Ad and C fibres were 9-0 and 0-9 m/s, respectively.4. Distension of a section of colon at up to 85-0 % of the length of the colon from the anus activated afferent fibres, and electrical stimulation of points at up to 102 % of this length elicited responses in efferent fibres.5. In dogs in which the continuity of the colonic wall was interrupted by a ligature but the nerves were left intact, the intramural pelvic nerves were found to convey centrifugal activities of the recto-and ano-colonic reflexes to the proximal colon, and centripetal and centrifugal activities of the colo-colonic reflex.

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Myanmar has one of the highest rates of diabetes in South-East Asia. This study aimed to determine prevalence and background characteristics of diabetic peripheral neuropathy and neuropathic pain, their effect on the functioning of hands and feet, and the impact on activities of daily living in people with type 2 diabetes mellitus. A total of 975 participants attending the outpatient clinics of four hospitals in Myanmar were interviewed using questionnaires in the local language about pain and difficulties in daily activities. The participants also underwent tests of physical functioning of both hands and feet. There was a high prevalence rate of neuropathy (33.7%) and neuropathic pain (59.5%), with an increased risk in old age, longer duration of diabetes, and history of smoking. The common difficulties in daily activities were sleeping, climbing stairs, walking, and work or chores. Participants with diabetic neuropathic pain experienced more difficulties in specific activities using upper and lower extremities than did those without. Healthcare service in Myanmar should be focused on diabetic peripheral neuropathy, as it can lead to further disabilities. K E Y W O R D Sactivities of daily living, diabetic peripheral neuropathic pain, diabetic peripheral neuropathy, Myanmar, prevalence

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