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Effects of exercises and manual therapy on nerve conduction studies of lower limb in patients with diabetes and diabetic peripheral neuropathy: A systematic review

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Background

Diabetes and related peripheral neuropathy result in various sensory and motor complications. Such changes are documented early and more precisely in nerve conduction studies than in clinical evaluation and quantitative sensory testing. Different exercises and mobilization also affect the same differently.

Objective

This review aimed to compile the current evidence on the effectiveness of exercises and manual therapy on nerve conduction studies of lower limbs in patients with diabetes and diabetic peripheral neuropathy and to evaluate the underlying mechanisms.

Methods

Studies that examined the effects of different exercises and manual therapy on nerve conduction studies of lower limbs in patients with diabetes mellitus and diabetic peripheral neuropathy were searched on available databases. The PRISMA statement was followed. Quality check was done using the Pedro scale.

Results

Thirteen studies matched the inclusion criteria. Interventions included moderate-intensity aerobic exercises, resistance exercises, tai chi exercises, sensorimotor and gait training, neurodynamic mobilization, and a combination of aerobics and resistance training.

Conclusion

The present systematic review suggests that 8 to 12 weeks of physical exercise improves nerve conduction velocity of the motor tibial, peroneal nerve, and sensory sural nerve in diabetes with or without peripheral neuropathy.

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Abbreviations

CMAP:

Compound muscle action potential

DM:

Diabetes mellitus

DPN:

Diabetic peripheral neuropathy

IENFD:

Intra epidermal nerve fiber density

NAPA:

Nerve action potential amplitude

NCS:

Nerve conduction studies

NCV:

Nerve conduction velocity

SNAP:

Sensory nerve action potential

PEDRO:

Physiotherapy evidence database

PRISMA:

Preferred reporting items for systematic reviews and meta-analysis

PICOS:

Population, intervention, comparison, outcomes, study design

TENS:

Transcutaneous electrical nerve stimulation

ADA:

American diabetes association

HbA1c:

Hemoglobin A1c

BMI:

Body mass index

QST:

Quantitative sensory testing

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Authors and Affiliations

  1. Department of Physiotherapy, School of Allied Health Sciences, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India

    Jyoti Sharma & Irshad Ahmad

  2. Department of Endocrinology, Metro Heart Institute With Multispecialty, Faridabad, Haryana, India

    Arun Kumar Chandresh Singh

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Sharma, J., Ahmad, I. & Singh, A.K.C. Effects of exercises and manual therapy on nerve conduction studies of lower limb in patients with diabetes and diabetic peripheral neuropathy: A systematic review. Int J Diabetes Dev Ctries (2023). https://doi.org/10.1007/s13410-023-01258-5

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