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J Manipulative Physiol Ther. 2014 May;37(4):242-52. doi: 10.1016/j.jmpt.2013.09.007. Epub 2014 Mar 20.

Multimodal treatment of distal sensorimotor polyneuropathy in diabetic patients: a randomized clinical trial.

Author information

1
Professor/Physician, Habilita, Istituto Clinico Ospedale di Sarnico, Sarnico, Italy.
2
Researcher, IRCCS Don Gnocchi Foundation, Milan, Italy.
3
Researcher, Mechanical and Industrial Engineering Department, University of Brescia, Brescia, Italy. Electronic address: alberto.borboni@ing.unibs.it.
4
Researcher, IRCCS Don Gnocchi Foundation, Milan, Italy; Professor/Physician, Director, Physical and Rehabilitation Medicine, University of Brescia, Brescia, Italy.

Abstract

OBJECTIVE:

The purpose of this study was to evaluate the effectiveness of the application of analyzing treadmill, muscle strengthening, and balance training compared with a standard care intervention in patients with diabetic neuropathy.

METHODS:

Twenty-seven patients, 63% female (mean ± standard deviations age, 72 ±9 years), with diabetic neuropathy randomly assigned to receive a multimodal manual treatment approach including analyzing treadmill with feedback focused, isokinetic dynamometric muscle strengthening, and balance retraining on dynamic balance platform or a standard care intervention for activities targeted to improve endurance, manual exercises of muscle strengthening, stretching exercises, gait, and balance exercises (5 weekly over 4 weeks). This study was designed as a double-blind, randomized clinical trial. Measures were assessed at pretreatment, 4 weeks posttreatment, and 2-month follow-up.

RESULTS:

No important baseline differences were observed between groups. At the end of the treatment period, the experimental group showed a significant increase in gait endurance in a 6-minute walk test, 65.6 m (F[2.0] = 9.636; P = .001). In addition, the 6-minute walk test increased after the intervention, and an even greater difference was found at follow-up (P = .005) for the standard care group. The Functional Independence Measure in both groups increased (P < .01) and continued until the follow-up in the standard care group (P = .003).

CONCLUSIONS:

The results suggest that the experimental rehabilitation program showed positive effects on the gait endurance after 4 weeks of treatment, whereas it did not produce significant improvements of the gait speed. Both the treatments produced significant improvement of functionalities of the patient.

KEYWORDS:

Gait Disorders; Muscle Strength; Neuropathy; Walking

PMID:
24656867
DOI:
10.1016/j.jmpt.2013.09.007
[Indexed for MEDLINE]

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