Exercise and Manual Therapy for Diabetic Peripheral Neuropathy: A Systematic Review

• Published in: Applied sciences 2021-06, Vol.11 (12), p.5665
• Main Authors: Hernández-Secorún, Mar, Vidal-Peracho, Concepción, Márquez-Gonzalvo, Sergio, Corral-de-Toro, Jaime, Müller-Thyssen-Uriarte, Julián, Rodríguez-Sanz, Jacobo, Lucha-López, María Orosia, Tricás-Moreno, José Miguel, Hidalgo-García, César
• Format: Article
• Language: English
• Subjects: Bias; Clinical trials; Complications; Decompression; Diabetes; Diabetes mellitus; diabetic neuropathies; Diabetic neuropathy; exercise; Glucose; Hyperglycemia; Insulin; Intervention; Kinases; Manipulative therapy; manual therapy; Metabolism; Metabolites; Nervous system; Pain; Patients; Peripheral neuropathy; Physical exercise; Systematic review
• ISSN: 2076-3417; 2076-3417
• DOI: 10.3390/app11125665

(1) Background: Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes mellitus (DM). Control of hyperglycaemia as well as surgical decompression are effective treatments for these patients. However, surgery is not indicated for all candidates. Manual therapy and physical exercise have been shown to be effective for peripheral neuropathies, and exercise for DM. The aim is to review the effectiveness of manual therapy and/or exercise in patients with DPN. (2) Methods: Randomised controlled clinical trials comparing the effects of manual therapy and/or exercise on pain, function and/or balance were selected. The search strategy was performed in PubMed, PEDro, Scopus, Cochrane and Web of Science databases. The PRISMA statement was followed. (3) Results: A total of 656 articles were registered, and 29 were selected. There was little consensus on DPN criteria selection. Aerobic, strength and balance exercises are beneficial for DPN. Sessions of 30–60 min, three times per week for 8 weeks seems to be the most used dose. Manual therapy is effective in the short term. A combination of both modalities was more beneficial than alone in one study. (4) Conclusions: Exercise and manual therapy are beneficial for patients with DPN. More studies should be carried out for analysing the potential effect of combining manual therapy and exercise.