The effect of therapeutic exercise on the treatment of symptoms and the delay of foot degeneration in patients with diabetic peripheral neuropathy: An evidenced-based physiotherapy review

Abstract

Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes. It presents with a symmetrical peripheral degeneration of peripheral nerves. Pain is a major complaint in about 1/3 of people with DPN and DPN-related sensory loss contributes to impaired balance, gait problems, and increased sensitivity to injury. Recent research has shown that a combination of aerobic exercise and resistance training improves fitness, glycemic control and insulin sensitivity in older adults and people with diabetes. The aim of this review was to investigate the effect of exercise on improving the symptoms of patients with DPN and delaying the onset of foot degeneration. The PubMed and Science Direct databases were searched with the following keywords: Diabetic neuropathy, therapeutic exercise, physiotherapy, rehabilitation. The results of this review suggest that exercise can improve the symptoms of DPN by reducing pain as well as improving gait accuracy, enhancing lower limb strength and improving the quality of daily life of patients. Aerobic exercise seems to be the type of training that provides the most benefits. There is also evidence that exercise in diabetic patients may either prevent or delay the onset of peripheral neuropathy. However, further clinical trials are required.