<p>Comparison of the effect of two therapeutic exercises on the inflammatory and physiological conditions and complications of diabetic neuropathy in female patients</p>

Abstract

Introduction and aimThe purpose of this study was to compare the effect of 12 weeks of low-intensity resistance training and exercises for peripheral neuropathy (EPN) on the inflammatory and physiological conditions, balance, and complications of diabetic neuropathy in female patients.Materials and methods45 women with mild to moderate diabetic neuropathy and an average age of 55.46±3.06 years voluntarily participated in the study. They were randomly assigned to either control (n=15), resistance (n=15), and EPN (n=15) groups. Both experimental groups were trained for 12 weeks (three sessions per week). EPN group did peripheral neuropathic exercises (12 lower extremity movements), and the resistance group performed their exercises with a 30% repetition maximum. During the intervention period, the control group only performed their daily activities. Blood samples were taken in both pre-test and post-test to investigate the levels of Tumor necrosis-α (TNF-α), Interleukin-10 (IL-10), C Reactive Protein (CRP), fast blood glucose (FBG) and Glycated hemoglobin (HbA1c). Complications of diabetic neuropathy were measured using the Michigan questionnaire and the Monofilament 10 g. In order to measure the balance, De Morton mobility index (DEMMI) was used.ResultsThe statistical analyses showed a significant decrease of FBG and HbA1c in the two experimental groups, as compared to the control group. TNF-α and CRP levels were decreased in both EPN and resistance groups, as compared to the control group. The observed increase in the serum IL-10 levels of the two experimental groups was not, however, significant, as shown in intra-group and inter-group comparisons. On the other hand, the two complications of pain and tingling in the lower limb extremities were improved in both experimental groups (p<0.05). However, the numbness complication showed no significant change (p=0.10). Static and dynamic balance was improved in the EPN group as well (p<0.05).ConclusionSince EPN exercises, in contrast to resistance exercises, are focused on the lower limb extremities and designed for diabetic neuropathy patients, they can improve the imbalance, pain and tingling, by significantly reducing TNF-α and CRP and improving the physiological conditions.

Effect of resistance training on chronic inflammation: A systematic review and meta‐analysis

“…The reference lists of eligible articles did not reveal additional articles. Therefore, full‐text review identified 59 studies that met the criteria for inclusion 12‐70 …”

“…The mean age ranged between 23 and 82 years, with an average of 53 years. Twenty‐seven of the 60 interventions (described in 59 studies) included middle‐aged adults (average 39‐62 years), where 17 included those with chronic disease, including type‐II diabetes mellitus, 20,31,32,44 renal disease, 12,16,21,36 metabolic syndrome, 25,34 chronic artery disease or hypertension, 14,63 fibromyalgia, 24 hemophilia, 49 human immunodeficiency virus, 69 multiple sclerosis, 33 and pancreatic cancer 48 . Ten included middle‐aged adults without reported diagnosed chronic disease, including those who were overweight or obese, 30,45,46,50 apparently healthy, 34,43 inactive, 35,58 and post‐menopausal 47,61 .…”

“…Data pertaining to the study population, exercise program, and outcome measures (pre‐ and post‐study means and standard deviation of (CRP, IL‐6, and TNF‐α) were extracted for each intervention 12‐70 . Where more than one timepoint throughout the intervention was provided, the pre‐ and post‐intervention values were extracted, and other intra‐intervention values omitted (n = 2).…”

“…Pooled standardized post‐mean difference (SMD) between resistance training and control groups for each analyte (CRP, IL‐6, and TNF‐α) were calculated using random‐effect meta‐analysis. This approach was used to account for the variability in the sample units provided among studies, 21,29,31,41‐44,49,50 and because, given only randomized studies were included, any difference between groups post‐intervention would be expected to be related to the intervention, as per guidelines from the Cochrane handbook for systematic reviews of interventions 72 . SMD and their respective 95% confidence intervals (95%CI) were calculated using the method of DerSimonian & Laird 72 .…”

Severe Vitamin D Deficiency Is Associated With Increased Expression of Inflammatory Cytokines in Painful Diabetic Peripheral Neuropathy

“…TNF-α also improves the channel function in sensory neurons and leads to peripheral nerve injury, thereby inducing pain ( 27 ). Nadi et al have found that exercises can significantly reduce TNF-α and CRP levels and have a consequent improvement in imbalance, pain and tingling ( 28 ). Our findings are in accordance with some previous reports.…”