A Systematic Review and Meta-Analysis on Efficacy of Exercise on Posture and Balance in Patients Suffering From Diabetic Neuropathy

PMID: 32619175 DOI: 10.2174/1573399816666200703190437

Abstract
Background: Peripheral neuropathy is a major and chronic complication of diabetes mellitus affecting more than 50% of patients suffering from diabetes. There is involvement of both large and small diameter nerve fibres leading to altered somatosensory and motor sensations, thereby causing impaired balance and postural instability.

Objective: To assess the effects of exercises on posture and balance in patients suffering from diabetes mellitus.

Method: Mean changes in Timed Up and Go test(TUGT), Berg Balance Scale and Postural Sway with eyes open and eyes closed on Balance System were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Eighteen randomized controlled trials met the selection criteria and were included in the study. All the studies ranked high on PEDro Rating scale. Risk of bias was assessed by Cochrane collaboration tool of risk of bias. Included studies had low risk of bias. Sixteen RCT's were included for the meta-analysis.

Result: Results of meta-analysis showed that there was statistically significant improvement in TUGT with p≤ 0.05 and substantial heterogeneity (I 2 = 84%, p < 0.00001) in experimental group as compared to control group. There was statistically significant difference in Berg Balance Scale scores and heterogeneity of I 2 = 62%, p < 0.00001 and significant changes in postural stability (eyes open heterogeneity of I 2 = 100%, p =0.01 and eyes closed, heteogeneity I 2 = 0%, p =0.01). Sensitivity analysis causes change in heterogeneity.

Conclusion: It can be concluded that various exercises like balance training, core stability, Tai-Chi, proprioceptive training etc. have a significant effect in improving balance and posture in diabetic neuropathy.

Keywords: Balance training.; Diabetes mellitus; Diabetic Neuropathy; Postural balance; Postural training.

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