Effect of Physical Therapy in Improving the Health of Patients With Diabetic Peripheral Neuropathy
Condition: Diabetic Neuropathies; Peripheral Nervous System Diseases
MeSH terms: Peripheral Nervous System Diseases; Diabetic Neuropathies; Nervous System Diseases
Study type: Interventional

Summary: 
      People with diabetes can have nerve damage in their extremities (peripheral neuropathy), and
      this can lead them to being less able to maintain their balance when they are standing,
      walking or performing complex movement tasks in their day-to-day life. This results in them
      being more prone to falls, and consequent injuries. The purpose of this study is to determine
      whether providing strength and balance retraining (in the form of specific physical exercises
      or activities) can help people with diabetic peripheral neuropathy regain their ability to
      maintain their balance, increase their confidence in performing balance-based activities and
      improve their quality of life.
    

Detailed description: 
      Individuals with diabetic peripheral neuropathy (DPN) comprise 16-24% of patients with
      diabetes mellitus in Singapore, and this is set to rise with the increasing prevalence of
      diabetes. DPN is also associated with the greatest reduction in health related quality of
      life (HRQoL) among all diabetic complications, specifically PCS (Physical health Component
      Summary) and its sub-components, physical functioning and physical role. However, there is
      currently no intervention that targets individuals with DPN for improvements in HRQoL and
      functional status.

      The investigators hypothesise that a targeted intervention providing strength and balance
      training will improve HRQoL and functional status in patients with DPN, which will be
      sufficiently large relative to increases in cost to make the intervention cost-efficient.

      The specific aims of the study are to test the effectiveness of a structured strength and
      balance training intervention in 1) improving the physical health component summary (PCS)
      measure of health related quality of life, 2) functional status, and 3) assessing
      cost-utility of the intervention, in individuals with diabetic peripheral neuropathy (DPN).
    

Intervention name(s): Strength & Balance Training
Intervention type(s): Other
Intervention description(s): Subjects will be guided through 8 weeks (1 hour per week) of home-based strength and balance training sessions. During each session, a trainer will guide subjects to perform muscle strengthening, range of motion, static balance, dynamic balance and endurance exercises, after an initial warm up. They will also be given advice on continuing such training as well as daily walking for the rest of the week.
Other intervention name(s): Exercise Training; Gait Training; Motor Learning; Balance performance; Physical activity; Physiotherapy; Guided-exercise
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Diabetes Mellitus; Diabetes Mellitus, Type 2; Diabetes Complications; Diabetic Foot; Diabetic Neuropathies; Gait; Balance, Postural; Muscle Strength; Exercise Therapy; Physical Therapy Modalities; Endocrine System Diseases; Peripheral Nervous System Diseases; Metabolic Diseases; Glucose Metabolism Diseases; Quality of Life; Training