PICO
Patient/Population
Patients aged 45–65 years with a history of diabetes >10 years and diagnosed symptoms of neuropathy. (n=60)
Intervention
- Endurance-Dominated Exercise Program
Comparison
- Waiting control
Outcomes
Maximal Oxygen Uptake (VO2max)
Target Heart Rate Frequency
- Walking Kinetics
- Muscle Activities
Translatability: (3/3) Easy
Comments: An endurance-dominated exercise program has the potential to improve VO2max and diabetes-related abnormal gait in patients with moderate DN. Authors recommend implementing endurance-dominated exercise programs in type 2 diabetic patients because it is feasible, safe, and effective to enhance aerobic capacity and gait characteristics.
Limitations: Kinetic and electromyographic data collected, but not kinematic; patients aged 45–65 years with moderate DN; loaded walking and step up exercises in our gait therapy protocol not used; diabetic patients with neuropathy only; only examined the stance phase of gait.
Appraisals:
PEDro Scale – (9/10) Blind therapists: No. (by PEDro – confirmed)
Trustworthiness – The study contains no serious weaknesses. Based on this result you should conclude that the trustworthiness of the study is high (90%). This means there is a 10% chance that alternative explanations for the effect found are possible. The effect size was large and medium-to-large, and 95% CI was OK. (by CAT for RCTS)
BTB
Intervention – 1
- Endurance-Dominated Exercise Program.
Dose
- 40–55 min. sessions.
Periodicity
- 12 weeks with 3 sessions per week.
Local/Technic:
Progressive training on a bike ergometer and gait therapy (i.e., continuous walking, stair climbing and descending, tandem walking, and walking sideways),in accordance with physical activity recommendations of the American Diabetes Association.
- Bike ergometer training intensity was individually determined using a graded exercise protocol on a bike ergometer and VO2max as an outcome measure.
- Gait therapy included continuous walking, stair climbing and descending, tandem walking and walking sideways. Exercises were incorporated into gait therapy if they targeted muscles that are specifically prone to weakness (e.g., medial gastrocnemius, tibialis anterior, and gluteus medius) in DN patients. The application of gait therapy may thus improve muscles within the kinetic chain that contribute to propulsion in multijoint movements such as walking.
Citation:
Jafarnezhadgero, A., Mamashli, E., & Granacher, U. (2021). An Endurance-Dominated Exercise Program Improves Maximum Oxygen Consumption, Ground Reaction Forces, and Muscle Activities in Patients With Moderate Diabetic Neuropathy. Frontiers in physiology, 12, 654755. https://doi.org/10.3389/fphys.2021.654755