The effect of exercise on neuropathic symptoms, nerve function, and cutaneous innervation in people with diabetic peripheral neuropathy
It is well known that exercise can significantly reduce the prevalence and severity of diabetic complications through a number of pathways (glycemic control, insulin sensitivity, vascular function and weight reduction).
Diabetic peripheral neuropathy (DPN) is present in 33% of people with diabetes aged 40 or older; a symmetrical distal degeneration of peripheral nerves combined with impaired nerve regeneration, affecting both large and small nerve fibers that lead to symptoms of pain and sensory loss. Pain is a primary complaint in approximately 1/3 of people with DPN. The sensory loss contributes to impaired balance and gait, and increased susceptibility to lower extremity injury and amputation.
Exercise may positively influence the pathological factors associated with neuropathy by promoting microvascular dilation, reducing oxidative stress, and increasing neurotrophic factors, but it is unknown whether exercise will improve or worsen the signs and symptoms of DPN. This pilot study examines direct effectiveness of a 10-week moderately intense (50-70% HRR) aerobic and strengthening exercise programme on nerve function (pain, neuropathic symptoms, nerve conduction and cutaneous innervation).
Despite the short duration of the intervention, significant improvements were found in pain (VAS), glycemic control (HbA1c), neuropathic symptoms (MNSI), resting heart rate (HR) and cutaneous innervation (biopsy). No improvements were found in BMI, waist circumference or nerve conduction (EMG). > From: Kluding et al., J Diabetes Complications 26 (2012) 424-429. All rights reserved to Elsevier, Inc.