The efficacy of physiotherapy interventions in mitigating the symptoms and complications of diabetic peripheral neuropathy: A systematic review

Akbari, Narges Jahantigh; Hosseinifar, Mohammad; Naimi, Sedigheh Sadat; Mikaili, Saeed; Rahbar, Soulmaz

doi:10.1007/s40200-020-00652-8

Cited by 21 publications

(13 citation statements)

References 63 publications

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“…Microvascular abnormalities, metabolic cascades, end products activated by hyperglycemia, inflammatory processes, oxidative stress, and cellular factors in patients with DM cause decreased blood flow, ischemia, and edema within the nerve [ 20 28 29 ], resulting in demyelination and axonal damage, also referred to as DPN [ 19 30 ]. The present study showed that in the diabetic group the axons of the sciatic nerve were obviously atrophic, demyelination was observed, and some myelinated fibers displayed Wallerian degeneration.…”

Section: Discussionmentioning

confidence: 99%

“…Viscoelasticity is an essential feature of biological tissues, including nerves that possess both viscous and elastic properties [ 18 ]. Furthermore, it was confirmed that microvascular abnormalities and inflammation are involved in the pathogenesis of DPN [ 19 20 21 ]. Therefore, the viscosity of nerves may be an important index for the detection of DPN.…”

Section: Introductionmentioning

confidence: 99%

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Quantification of Nerve Viscosity Using Shear Wave Dispersion Imaging in Diabetic Rats: A Novel Technique for Evaluating Diabetic Neuropathy

Liu

Xin

et al. 2022

Korean J Radiol

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Objective Viscoelasticity is an essential feature of nerves, although little is known about their viscous properties. The discovery of shear wave dispersion (SWD) imaging has presented a new approach for the non-invasive evaluation of tissue viscosity. The present study investigated the feasibility of using SWD imaging to evaluate diabetic neuropathy using the sciatic nerve in a diabetic rat model. Materials and Methods This study included 11 diabetic rats in the diabetic group and 12 healthy rats in the control group. Bilateral sciatic nerves were evaluated 3 months after treatment with streptozotocin. We measured the nerve cross-sectional area (CSA), nerve stiffness using shear wave elastography (SWE), and nerve viscosity using SWD imaging. The motor nerve conduction velocity (MNCV) was also measured. These four indicators and the histology of the sciatic nerves were then compared between the two groups. The performance of CSA, SWE, and SWD imaging in distinguishing the two groups was assessed using receiver operating characteristic (ROC) analysis. Results Nerve CSA, stiffness, and viscosity in the diabetic group was significantly higher than those in the control group (all p < 0.05). The results also revealed a significantly lower MNCV in the diabetic group ( p = 0.005). Additionally, the density of myelinated fibers was significantly lower in the diabetic group ( p = 0.004). The average thickness of the myelin sheath was also lower in the diabetic group ( p = 0.012). The area under the ROC curve for distinguishing the diabetic neuropathy group from the control group was 0.876 for SWD imaging, which was significantly greater than 0.677 for CSA ( p = 0.030) and 0.705 for SWE ( p = 0.035). Conclusion Sciatic nerve viscosity measured using SWD imaging was significantly higher in diabetic rats. The viscosity measured using SWD imaging performed well in distinguishing the diabetic neuropathy group from the control group. Therefore, SWD imaging may be a promising method for the evaluation of diabetic neuropathy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quantification of Nerve Viscosity Using Shear Wave Dispersion Imaging in Diabetic Rats: A Novel Technique for Evaluating Diabetic Neuropathy

Liu

Xin

et al. 2022

Korean J Radiol

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“…Emerging technologies, pharmacology and therapeutics such as exercise therapy, electrotherapy, and other physiotherapy methods, exercise therapy has been the most effective. 14 Studies have shown that supervised exercise improves cardiorespiratory function, innervation, [15][16][17] nerve conduction, 18 muscle strength, balance, 19 and reduces pain interference. 20 However, the effects of exercise on key DPN markers such as lower extremity muscle adiposity, nerve microarchitecture, and muscle metabolism have yet to be reported.…”

Section: Significance Of This Studymentioning

confidence: 99%

Lower extremity MRI following 10-week supervised exercise intervention in patients with diabetic peripheral neuropathy

Brown

Sharafi

Slade

et al. 2021

BMJ Open Diab Res Care

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IntroductionThe purpose of this study was to characterize using MRI the effects of a 10-week supervised exercise program on lower extremity skeletal muscle composition, nerve microarchitecture, and metabolic function in individuals with diabetic peripheral neuropathy (DPN).Research design and methodsTwenty participants with DPN completed a longitudinal trial consisting of a 30-day control period, during which subjects made no change to their lifestyle, followed by a 10-week intervention program that included three supervised aerobic and resistance exercise sessions per week targeting the upper and lower extremities. The participants’ midcalves were scanned with multinuclear MRI two times prior to intervention (baseline1 and baseline2) and once following intervention to measure relaxation times (T1, T1ρ, and T2), phosphocreatine recovery, fat fraction, and diffusion parameters.ResultsThere were no changes between baseline1 and baseline2 MRI metrics (p>0.2). Significant changes (p<0.05) between baseline2 and postintervention MRI metrics were: gastrocnemius medialis (GM) T1 –2.3%±3.0% and soleus T2 –3.2%±3.1%. Trends toward significant changes (0.05<p<0.1) between baseline2 and postintervention MRI metrics were: calf adipose infiltration –2.6%±6.4%, GM T1ρ –4.1%±7.7%, GM T2 –3.5%±6.4%, and gastrocnemius lateral T2 −4.6±7.4%. Insignificant changes were observed in gastrocnemius phosphocreatine recovery rate constant (p>0.3) and tibial nerve fractional anisotropy (p>0.6) and apparent diffusion coefficient (p>0.4).ConclusionsThe 10-week supervised exercise intervention program successfully reduced adiposity and altered resting tissue properties in the lower leg in DPN. Gastrocnemius mitochondrial oxidative capacity and tibial nerve microarchitecture changes were not observed, either due to lack of response to therapy or to lack of measurement sensitivity.

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“…Plantar ulceration and amputation, the disease's most fatal outcome, can still be avoided if proper measures are applied. 4 …”

Section: Introductionmentioning

confidence: 99%

Effect of Antigravity Treadmill Training on Gait and Balance in Patients with Diabetic Polyneuropathy: A Randomized Controlled Trial

Abdelaal

El-Shamy²

2022

F1000Res

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Background: Diabetic polyneuropathy (DPN) is the most prevalent consequence of diabetes mellitus, and it has a significant impact on the patient's health. This study aims to evaluate effects of antigravity treadmill training on gait and balance in patients with DPN. Methods: The study included 45 males with type 2 diabetes who were randomly assigned to one of two groups: the experimental group (n=23) or the control group (n=22). For a period of 12 weeks, the experimental group received antigravity treadmill training (75% weight bearing, 30 min per session, three times per week) combined with traditional physical therapy. During the same time period, the control group received only traditional physical therapy. The Biodex Balance System was used to assess postural stability indices, while the GAITRite Walkway System was used to assess spatiotemporal gait parameters. All measurements were obtained before and at the end of the study after 12 weeks of treatment. Results: The mean values of all measured variables improved significantly in both groups (P<0.05), with the experimental group showing significantly greater improvements than the control group. The post-treatment gait parameters (i.e., step length, step time, double support time, velocity, and cadence) were 61.3 cm, 0.49 sec, 0.25 sec, 83.09 cm/sec, and 99.78 steps/min as well as 56.14 cm, 0.55 sec, 0.29 sec, 75.73 cm/sec, and 88.14 steps/min for the experimental and control group, respectively. The post-treatment overall stability index was 0.32 and 0.70 for the experimental and control group, respectively. Conclusions: Antigravity treadmill training in combination with traditional physical therapy appears to be superior to traditional physical therapy alone in terms of gait and balance training. As a result, the antigravity treadmill has been found to be an effective device for the rehabilitation of DPN patients.

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The efficacy of physiotherapy interventions in mitigating the symptoms and complications of diabetic peripheral neuropathy: A systematic review

Cited by 21 publications

References 63 publications

Quantification of Nerve Viscosity Using Shear Wave Dispersion Imaging in Diabetic Rats: A Novel Technique for Evaluating Diabetic Neuropathy

Quantification of Nerve Viscosity Using Shear Wave Dispersion Imaging in Diabetic Rats: A Novel Technique for Evaluating Diabetic Neuropathy

Lower extremity MRI following 10-week supervised exercise intervention in patients with diabetic peripheral neuropathy

Effect of Antigravity Treadmill Training on Gait and Balance in Patients with Diabetic Polyneuropathy: A Randomized Controlled Trial

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