Song et al. 2011 |
South Korea |
44/6 |
8 weeks |
DM and DPN |
Skeletal muscle impairment, fracture or malformation, severe osteoarthritis, CNS and SV dysfunctions, postural hypotension, mental deficiency, and psychiatric disorders |
Physical activities for balance and proprioception of the trunk Education to improve health for DM |
Education for DM |
1. Static balance: Body sway distance test, unipedal stance test. 2. Dynamic balance: BBS, TUG, FRT, 10-m walking test. 3. Proprioception of the trunk: TREs |
Kruse et al. 2010 |
United States |
79/5 |
12 months |
T1DM or T2DM and DPN, not having participated in weight lifting exercises for 20 min more than twice a week, loss of sensitivity of at least 1 in 10 points in the feet, loss of vibration sensitivity |
Medical contraindication to perform physical activity |
Part 1 (1 to 3 months): Physical activities for balance and leg strengthening (8 weeks + 3 weeks more intensively) Program included walking, adapted to the physical capacity of each patient Part 2 (4 to 12 months): Motivational calls for the maintenance of the performance of the activities above, instructions for self-care regarding DM and medical care |
Instructions for self-care regarding DM and medical care |
1. Static balance: Unipedal stance test. 2. Dynamic balance: BBS, TUG. 3. Ankle muscle strength: dynamometer. 4. Fall: two scales (Falls Efficacy Scale and Function Index Disability Scale) and incidence of one or ≥2 falls throughout the study |
Allet et al. 2010 |
Switzerland |
71/3 |
12 weeks |
T2DM and DPN (diagnosis based on Rydel-Seiffer tuning fork). No medical contraindication to perform physical activity |
Ulcers on the feet, non-diabetic neuropathy, other neurological pathologies that influenced the gait and the incapacity to walk 500 m without support |
Twice a week, 60 min, warm-up (5 min), circuit (40 min) that included gait and balance activities, interactive games (10 min) and feedback with suggestions of home exercises (5 min) |
Patients have been instructed to maintain their leisure activities, but with no specific orientation |
1. Static balance: Postural control by the Biodex Balance System platform (New York, USA) 2. Dynamic balance: Tinetti balance assessment (Performance Oriented Mobility Assessment – POMA), walking as fast and accurately as possible on a 5-meter beam (height: 15 cm and width: 15 cm) 3. Gait: Outdoor gait assessment (Physilog; BioAGM, Lausanne, Switzerland) 4. Fall: Concern of falling was assessed by the Fall Efficacy Scale International (FES-I) |
Sartor et al. 2014 |
Brazil |
55/16 |
12 weeks |
T1DM or T2DM for at least 7 years, BMI 18.5-29.9 kg/m², DPN (scoring higher than 2 in a maximum of 13 points in the MNSI scale), vibration sensitivity alteration, ability to walk independently, absence of plantar ulceration and amputation |
Other neurological and orthopedic disabilities, severe vascular complications, severe retinopathy, or nephropathy |
Twice a week, 60 min, exercises to improve the movements of the feet and ankles, strengthen the foot and ankle muscles, increase the ability of walking and foot rollover training |
No recommendation regarding physical activity, but medical care was provided continuously |
1. Peak pressure on the plantar surface: Peak pressure on the lateral forefoot 2. Foot rollover 3. Kinematic and kinetic variables of the ankle joint 4. Clinical variables (feet physical exam and MNSI) |
Dixit et al. 2014 |
India |
87/21 |
8 weeks |
T2DM and DPN (with minimum score of 7 in MDNS) |
Vitamin B12 deficiency, postural hypotension, foot ulcers, use of walking aids, amputation, PAD, other therapies for DPN and age above 70 years |
Aerobic activities according to the AHA guidelines and medical, nutritional, and pedal care |
Medical, nutritional, and pedal care |
1. Electrophysiological evaluation: Peroneal and sural sensory motor nerves 2. Evaluation of the Michigan Diabetic Neuropathy Score(MDNS) |
Lee et al. 2013 |
South Korea |
40/4 |
6 weeks |
DM and DPN (medical diagnosis), ≥65 years, two or more falls in the last 12 months, one fall in the TUG or recurrent inexplicable falls |
Muscle skeletal disability, MMSE scoring less than 24/30 |
Training on a vibration platform (Galileo 2000, Novotec Medical GmBH, Germany) (three times a week and 3 min/day) and/or twice a week, 60 min, warm-up (10 min), balance activities (40 min), stretching (10 min) |
No participation in physical training |
1. Static balance: Body sway distance test, unipedal stance test. 2. Dynamic balance BBS, TUG, FRT. 3. MMII Muscle strengthening: FTSTS. 4. HbA1c |
Grewal et al. 2015 |
United States & Qatar |
39/5 |
4 weeks |
Ability to walk independently for 20 m and medically diagnosed type 2 diabetes with DPN. DPN was confirmed using the criteria explained in the American Diabetes Association |
Presence of cognitive, vestibular, or central neurological dysfunction, musculoskeletal abnormality, active foot ulcers, Charcot's joints, or a history of balance disorder unrelated to DPN |
A sensor-based exercise training with real-time visual feedback from the joint motion of the lower extremities to improve the postural stability and activity level + Standard of care |
Standard care |
1.Fall: Concern of falling was assessed by the Fall Efficacy Scale International (FES-I) 2. Quality of life: Short-form health survey (SF-12) 3. Balance: Postural stability was assessed barefoot in double stance for 30 s with open and closed eyes using a two-link biomechanical model 4. Daily physical activities monitored for 48 h |
Kutty et al. 2013 |
India |
32/? |
6 weeks |
Type 2 diabetes, without medical contraindications of engaging in physical activity and with clinically diagnosed diabetic peripheral neuropathy |
Concomitant foot ulcers, orthopedic or surgical problems affecting gait variables, nondiabetic neuropathy, and other neurological pathologies |
A multisensory exercise program for 30 minutes, 3 times a week over 6 weeks + Usual leisure activities |
Usual leisure activities |
1. Dynamic balance: TUG, Six-Minute Walk Test |