Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Effects of Customized Proprioceptive Training and Balance Exercises among Diabetic Patients


Affiliations
1 MPT Neurology, India
2 KLE University’s Institute of Physiotherapy, Belgaum-10, Karnataka, India
     

   Subscribe/Renew Journal


Background and Objectives

Diabetes mellitus (DM) is a prevalent disease considered to be a Public Health problem, with high social and economic costs1. Among the clinical complications of DM there are blindness, renal insufficiency, peripheral neuropathy2,3 and many more. Peripheral neuropathy seems to develop as an autonomic and sensorial disturbance and as a progressive and irreversible motor disease4. It can interrupt the afferent and efferent functions of the lower extremities that are responsible for maintaining normal posture and normal walking5. As a consequence, proprioception is lost hence balance is lost. Little is known about possible treatment strategies. This study evaluates the effects of a customised training programme on proprioception and balance in diabetic patients.

Methodology

The present clinical trial was conducted among 20 patients (n=20) referred to K.L.E'S Institute of Physiotherapy who were clinically diagnosed with diabetes and fulfilling the inclusion criteria. Ethical clearance was obtained from the institution. Written informed consent was taken from the participants. The intervention consisted of physiotherapeutic training including proprioceptive and balance exercises (daily over 1 month). Outcome measures used in the study was Berg Balance scale, Falls Efficacy Scale International & was measured before and after completion of therapy.

Results

After intervention, the subjects showed improved balance (p=0.000) and the FES-I score (p=0.000) which were highly significant. Results of the study are highly significant and confirmed that approach to balance in diabetes mellitus patients should be customised. Customised Proprioception&Balance training is effective in diabetic patients which (BBS score, p =.0000) reduced risk of falls (FES, p= .000) in diabetics. Findings are being well co related with previous findings of balance and proprioceptive trainings which proved to be effective1-6.

Conclusion

A customized proprioceptive and balance training programme based on a individual needs and functional limitations can improve proprioception and balance and also decrease the risk of falls.


Keywords

Diabetes Mellitus, Proprioceptive Training, Balance Exercises, Berg Balance Scale, Fall Efficacy Scale
Subscription Login to verify subscription
User
Notifications
Font Size


  • Preston C International Diabetes Federation : Raising public awareness around the world. World Health Organisation, World Diabetes Newsletter, Geneva 1998:4.
  • Sattin RW. Falls among older persons: a public health perspective. Ann Rev Public Health. 1992;13:489–508.
  • Fried L, Guralnik JM. Disability in older adults: evidence regarding significance, etiology and risk. J Am Geriatr Soc. 1997;45:92–100.
  • L Allet et al.The gait & balance of patients with diabetes can be improved, An RCT. Diabetologia. Nov 2009:1592-94.
  • Santos AAI; Bertato FTII; Montebelo MILI, Guirro ECOI. Effect of proprioceptive training among diabetic women. May/June 2008: vol.12 no.3.
  • Leonard DR, Farooqui H, Myers F, Myers S. Restoration of sensation, reduced pain, and improved balance in subjects with diabetic peripheral neuropathy: a double-blind, randomized, placebo-controlled study with monochromatic near-infrared treatment. Diabetes Care. 2004;27(1):168-72.
  • Morrison et al. Balance training reduces falls risk in elder individuals with type II DM. Diabetic care (4) April 2010: 748- 50.
  • Judge JO et al. Balance improvements in older females: exercise training. April(1993);73(4) :254-62.
  • Cimbiz A, Cakir O. Evaluation of balance and physical fitness in diabetic neuropathic patients. J Diabetes Complications. 2004;19(3):160-4.
  • Maurer MS, Burcham J, Cheng H (2005) Diabetes mellitus is associated with an increased risk of falls in elderly residents of a long-term care facility. J Gerontol A Biol Sci Med Sci 60:1157–1162
  • Gillespie LD, Gillespie WJ et al (2003) Interventions for preventing falls in elderly people. Cochrane database Syst Rev : CD000340.
  • Fife D, Barancik JI. Northeastern Ohio Trauma Study III: incidence of fractures. Ann Emerg Med. 1985;14:244–248.
  • Malmivaara A, Heliovaara M, Knekt P, Reunanen A, Aromaa A. Risk factors for injurious falls leading to hospitalization or death in a cohort of 19,500 adults. Am J Epidemiol. 1993;138:384–394.
  • Cumming RG, Kelsey JL, Nevitt MC. Methodologic issues in the study of frequent and recurrent health problem. Falls in the elderly. Ann Epidemiol. 1990;1:49–56.
  • Lucy Yardley et al. Development and initial validation of the Falls Efficacy Scale International (FES-I): Vol 34 issue 6:614-619.
  • Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–1707.
  • De Berardis G, Pellegrini F, Franciosi M, Belfiglio M, Di Nardo B, Greenfield S, et al. Are Type 2 diabetic patients offered adequate foot care? The role of physician and patients characteristics. J Diabetes Complications. 2005;19(6):319- 27.

Abstract Views: 394

PDF Views: 0




  • Effects of Customized Proprioceptive Training and Balance Exercises among Diabetic Patients

Abstract Views: 394  |  PDF Views: 0

Authors

Nandini B. Kadabi
MPT Neurology, India
Sanjiv Kumar
KLE University’s Institute of Physiotherapy, Belgaum-10, Karnataka, India

Abstract


Background and Objectives

Diabetes mellitus (DM) is a prevalent disease considered to be a Public Health problem, with high social and economic costs1. Among the clinical complications of DM there are blindness, renal insufficiency, peripheral neuropathy2,3 and many more. Peripheral neuropathy seems to develop as an autonomic and sensorial disturbance and as a progressive and irreversible motor disease4. It can interrupt the afferent and efferent functions of the lower extremities that are responsible for maintaining normal posture and normal walking5. As a consequence, proprioception is lost hence balance is lost. Little is known about possible treatment strategies. This study evaluates the effects of a customised training programme on proprioception and balance in diabetic patients.

Methodology

The present clinical trial was conducted among 20 patients (n=20) referred to K.L.E'S Institute of Physiotherapy who were clinically diagnosed with diabetes and fulfilling the inclusion criteria. Ethical clearance was obtained from the institution. Written informed consent was taken from the participants. The intervention consisted of physiotherapeutic training including proprioceptive and balance exercises (daily over 1 month). Outcome measures used in the study was Berg Balance scale, Falls Efficacy Scale International & was measured before and after completion of therapy.

Results

After intervention, the subjects showed improved balance (p=0.000) and the FES-I score (p=0.000) which were highly significant. Results of the study are highly significant and confirmed that approach to balance in diabetes mellitus patients should be customised. Customised Proprioception&Balance training is effective in diabetic patients which (BBS score, p =.0000) reduced risk of falls (FES, p= .000) in diabetics. Findings are being well co related with previous findings of balance and proprioceptive trainings which proved to be effective1-6.

Conclusion

A customized proprioceptive and balance training programme based on a individual needs and functional limitations can improve proprioception and balance and also decrease the risk of falls.


Keywords


Diabetes Mellitus, Proprioceptive Training, Balance Exercises, Berg Balance Scale, Fall Efficacy Scale

References