Consideration Of Chronic Pain In Trials To Promote Physical Activity For Diabetes: A Systematic Review Of Randomized Controlled Trials

Riva, John J.; Wong, Jessica J.; Brunarski, David; Chan, Alice H. Y.; Lobo, Rebecca; Aptekman, Marina; Alabousi, Mostafa; Imam, Maha; Gupta, Anita; Busse, Jason W.

doi:10.1371/journal.pone.0071021

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…Few RCTs have specifically examined the effects of exercise training on chronic pain in people with type 2 diabetes. In a systematic review of 136 RCTs investigating interventions to improve physical activity levels in people with diabetes, only one reported chronic pain measures at baseline and no trials investigated chronic pain as a target of the intervention [30]. Since this review, the Italian Diabetes and Exercise study published data from their RCT of 606 inactive people with type 2 diabetes comparing twice weekly supervised aerobic and resistance training plus counselling versus counselling alone for 12 months [11].…”

Section: Discussionmentioning

confidence: 99%

Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes – Preliminary randomised controlled trial

Cox

Gajanand

Burton

et al. 2020

Diabetes Research and Clinical Practice

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People with type 2 diabetes (T2D) have a greater prevalence of musculoskeletal and neuropathic pain. This exploratory analysis investigated whether exercise of different intensities leads to changes in self-reported musculoskeletal pain or symptoms of diabetic neuropathy in inactive individuals with type 2 diabetes. Methods: Thirty-two inactive adults with T2D (59% male, mean age 58.7±9.1yrs, median HbA1c 7.8%) were randomised to usual care (CON), supervised combined aerobic and resistance moderate-intensity continuous training (C-MICT), or supervised combined highintensity interval training (C-HIIT). At baseline and 8-weeks, musculoskeletal and neuropathic pain were evaluated using a modified Nordic Musculoskeletal Questionnaire and the Neuropathy Total Symptom Score-6 respectively. Quantitative sensory testing was used to determine thermal, mechanical and vibration detection thresholds, as well as pain pressure thresholds. Adverse events were recorded throughout the intervention.Results: Compared to CON, reduction in musculoskeletal pain intensity was significantly greater for C-HIIT (MD -5.4, 95% CI [-10.6 to -0.2], p=0.04) and non-significantly greater for C-MICT (MD -5.9 [-12.4 to 0.7], p=0.08). Changes in neuropathy symptoms were not different between C-HIIT and CON (MD 1.0 [-0.9 to 2.8], p=0.31), or C-MICT and CON (MD 0.2 [-3.1 to 3.6], p=0.89). No differences in sensory function were observed between groups. Similar rates of adverse events were seen in both exercise interventions (19 C-HIIT; 17 C-MICT), all but one of which were mild. Conclusions:Preliminary data suggests 8-weeks of high-intensity combined aerobic and resistance exercise may be safely prescribed for inactive individuals with T2D and may reduce musculoskeletal pain but not neuropathic symptoms.

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Section: Discussionmentioning

confidence: 99%

Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes – Preliminary randomised controlled trial

Cox

Gajanand

Burton

et al. 2020

Diabetes Research and Clinical Practice

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“…In the aforementioned Cochrane review, only 25% of the studies included actively reported adverse events [87]. Another systematic review of randomized controlled trials in people with T2D found only 1 of the 136 exercise trials evaluated pain at baseline, and no trials were designed to specifically target the chronic pain [110]. The Italian Diabetes and Exercise Study used tailored exercise programs to minimize the risk of injury and worsening of RMS so to improve exercise adherence [85].…”

Section: Evaluation Of Rheumatological and Musculoskeletal Symptoms And Chronic Painmentioning

confidence: 99%

Not a Painless Condition: Rheumatological and Musculoskeletal Symptoms in Type 2 Diabetes, and the Implications for Exercise Participation

Cox

Coombes

Keating

et al. 2020

CDR

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Objectives: People with type 2 diabetes (T2D) are more likely to develop a range of rheumatological and musculoskeletal symptoms (RMS), and experience both chronic and widespread pain, compared with the general population. However, these symptoms are not commonly acknowledged by researchers, which hampers our understanding of the impact on this population. Since exercise is a key lifestyle management strategy for T2D and participation levels are typically low, understanding the potential impact of RMS on exercise participation is critical. The aim of this review is to summarise the literature regarding the prevalence and pathophysiology of RMS in T2D, the evidence for the benefits and risks associated with exercise on RMS, and the currently available tools for the reporting of RMS in both research studies and community settings. Methods: A narrative review. Results: There are numerous exercise trials in T2D, but few have sufficiently reported pain-related adverse events and even fewer have investigated the effects of exercise on RMS and chronic pain. Discussion: Recommendations for future research are provided.

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“…Боль при ОА и СД2Т является общим и основным клиническим симптомом, ограничивающим трудоспособность. В частности, 60% больных СД2Т испытывают хроническую боль, связанную со снижением толерантности к глюкозе [162]. Кроме того, у больных СД2Т часто наблюдается боль в спине, верхних и нижних конечностях, абдоминальная и нейропатическая боль [163][164][165].…”

Section: молекулярные механизмы боли при остеоартрите и сахарном диабетеunclassified

there any association of metabolic disturbances with joint destruction and pain?

2019

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Osteoarthritis and type 2 diabetes mellitus represent two the most common chronic diseases. They possess many shared epidemiologic traits, have common risk factors, and embody heterogeneous multifactorial pathologies, which develop due to interaction of genetic an environmental factors. In addition, these diseases are often occurring in the same patient. In spite of the differences in clinical manifestation both diseases have similar disturbances of cellular metabolism, primarily associated with ATP production and utilization. The review discusses molecular mechanisms determining pathophysiological processes associated with glucose and lipid metabolism as well as the means aiming to alleviate the disturbances of energy metabolism as a new a therapeutic approach.

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Consideration Of Chronic Pain In Trials To Promote Physical Activity For Diabetes: A Systematic Review Of Randomized Controlled Trials

Cited by 7 publications

References 17 publications

Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes – Preliminary randomised controlled trial

Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes – Preliminary randomised controlled trial

Not a Painless Condition: Rheumatological and Musculoskeletal Symptoms in Type 2 Diabetes, and the Implications for Exercise Participation

there any association of metabolic disturbances with joint destruction and pain?

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