The Effects of a 12-Week-Long Sand Exercise Training Program on Neuromechanical and Functional Parameters in Type II Diabetic Patients with Neuropathy

Abstract

Studies have proven the effectiveness of different weight-bearing exercise interventions for diabetic patients with neuropathy; however, several adverse effects were reported using solid surfaces. Thus, in the present study, we investigated the effects of a novel sand exercise training intervention on biomechanical and functional parameters in seven diabetic patients (age = 62.7 ± 9.7 years) with neuropathy. Patients underwent a 12-week sand exercise training program, using strengthening, stretching, balance, and gait exercises. They were tested for ankle plantar- and dorsiflexion peak torque, active range of motion (ROM), timed up and go (TUG), and bilateral static balance. EMG activity of tibialis anterior (TA), gastrocnemius medialis (GM), and lateralis (GL) muscles were measured during unilateral isometric contraction in plantar- and dorsiflexion. In the intervention period, plantarflexion peak torque improved significantly (p = 0.033), while dorsiflexion torque remained unchanged. Plantar- and dorsiflexion ROM increased (p = 0.032) and (p = 0.021), respectively. EMG activity of GM (p = 0.005) and GL (p = 0.002) measured during dorsiflexion and postural sway in the balance test, as well as time to complete the TUG test, decreased significantly (p = 0.021) and (p = 0.002), respectively. No adverse effect was reported during the intervention period. We concluded that sand exercise training can be a safe and effective method to improve plantarflexion strength, ankle flexibility, and balance, which is reflected in better gait function in patients with diabetic peripheral neuropathy (DPN).

Effectiveness of Rebounder and Foot-ankle Exercises on Biomechanics and Quality of Life in Peripheral Neuropathy Patients

“…These results were consistent with the findings of Kankanasamut et al [29], Sartor et al [31], Fayed et al [32], Cerrahoglu et al [33], Jorgetto et al [8], Jiang et al [3], Prokai et al [1], de Oliveira Lima et al [34], and Monterio et al [10]. Kankanasamut et al [29] demonstrated that eight weeks of weight-bearing exercises increases vibration perception.…”

“…Prokai et al [1] demonstrated that a 12-week exercise program on the sand, including strengthening, stretching, balance, and walking exercises is a safe and effective method for improving plantar flexion strength, ankle flexibility, and balance, which manifests in better walking performance in patients suffering from diabetic peripheral neuropathy.…”

“…urrently, more than 500 million adults are living with diabetes worldwide, with nearly half of them suffering from various kinds of neuropathy [1][2][3][4]. In line with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), diabetes implications are growing rapidly and diabetic peripheral neuropathy (DPN) is the maximum common microvascular consequence, influencing as much as 70% of sufferers from diabetes [5].…”

“…Furthermore, the psychosocial impacts of diabetic neuropathy impair a person's quality of life (QoL) [9]. Diabetic neuropathy, which has a detrimental influence on postural balance, alterations in walking kinematics, and deficiencies in proprioception, raises the risk of falling, which is most closely associated with depressive symptoms in diabetic patients [1][2][3].…”

The Relationship between Muscle Ultrasound Parameters and Diabetic Peripheral Neuropathy among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

“…Muscle ultrasound has been used to assess muscle mass and muscle quality among young athletes and has been applied to older people recently [ 16 ]. Studies have shown that ultrasound could detect muscle atrophy by measuring CSA, MT, and shear wave velocity (SWV) for foot muscles directly related to foot ulcers and other complications [ 15 , 17 , 18 ]. For large muscle groups of lower extremities, Wang et al [ 19 ] discovered that diabetes duration over ten years and rectus femoris mass index (RFMI) lower than 2.2 cm 2 /m 2 were indicators of DPN with an accuracy of 0.75 (95% CI: 0.72–0.79, p < 0.001).…”