The effect of non-impact resistance exercises on patients with diabetic neuropathy: Acute responses and long-term adaptations
- Alejandro Meana-Esteban
- Prof. Patricia Price (Wound Healing Research Unit, School of Medicine, Cardiff University)
- Prof. Keith Harding (Wound Healing Research Unit, School of Medicine, Cardiff University)
- Dr Robert van Deursen
Foot ulceration in patients with diabetic neuropathy is a major health problem, often leading to further complications. The loss of protective sensation secondary to neuropathy is considered an important factor for ulcer occurrance in this population However neuropathy by itself is not the only factor responsible for ulceration; other abnormalities associated with this condition such as peak plantar pressures and impairments in micro-circulation have also been reported to play a crucial role.
Studies with diabetic patients have demonstrated that physical training improves the cardiovascular risk profile in this population reducing the risk of cardiovascular events in this population. However the role physical activity may have in both enhancing microcirculation and reducing foot pressures when walking is still far from clear. In addition to that physical activity guidelines for peripheral neuropathic populations are based on evidence from studies with non-neuropathic diabetic people whereas no attempt has been made to demonstrate the positive effect of exercise training on this neuropathic population. In order to avoid the potential, serious consequences of peripheral neuropathy, impact-activities such as walking and jogging should be excluded from the exercise recommendations.
Therefore, this study aims to determine to what extend low impact activities have a positive effect on foot pressures and microcirculation in patients with peripheral neuropathy within a context of a long-term aerobic training programme.
Range of motion of the lower limbs using goniometers, muscular microcirculation using Near Infra-Red Spectrometry, plantar pressures using the pressure mat system and strength of the knee extensors, knee flexors, ankle dorsiflexors and ankle plantarflexors are assessed before and after the intervention.