diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM9804diaendo-9804Research ArticleОригинальные исследованияOriginal StudiesСтруктурированная программа упражнений на биомеханику нижних конечностей среди пациентов с сахарным диабетом 2 типа с полинейропатией и без нееStructured exercise program on Foot Biomechanics & Insulin Resistance among people living with type 2 diabetes with and without peripheral neuropathyhttps://orcid.org/0000-0002-4744-0180KumarAmaravadi Sampath

PhD, Department of Physiotherapy

sampathkpt@gmail.comhttps://orcid.org/0000-0001-8057-8803HazariAnimesh

PhD, Department of Physiotherapy

animeshh8@gmail.comhttps://orcid.org/0000-0001-7573-0137MaiyaArun G

Dean & Professor, Department of Physiotherapy

arun.maiya.g@gmail.comhttps://orcid.org/0000-0001-7630-5028ShastryBarkur A.

Professor, Department of General Medicine

shastryba@yahoo.co.inhttps://orcid.org/0000-0003-2466-9457NagiriShivashankara K

Professor, Department of General Medicine

shi.sha@manipal.eduhttps://orcid.org/0000-0003-4150-5729KVaishali

BPT, MPT, PhD, Professor, Department of Physiotherapy

vaishali.kh@manipal.edu<p>School of Allied Health Sciences, Manipal Academy of Higher Education</p>India<p>Kasturba Hospital</p>India2019080420192215361Copyright &#x00A9; Kumar A., Hazari A., Maiya A., Shastry B., Nagiri S., K V., 20192019Kumar A., Hazari A., Maiya A., Shastry B., Nagiri S., K V.Kumar A., Hazari A., Maiya A., Shastry B., Nagiri S., K V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/9804Введение

Введение. Биомеханические изменения нижних конечностей у пациентов с сахарным диабетом 2 типа (СД2) часто приводят к различным осложнениям стопы, которые могут еще больше усугубить заболеваемость и смертность, связанные с диабетом. Эти изменения возникают по причине костно-мышечных изменений, таких как снижение силы мышц стопы, упругости мышц нижних конечностей, постуральных изменений и т.д.

Цель

Цель. Разработать и определить эффективность структурированной программы упражнений на кинетику и кинематику нижних конечностей среди пациентов с СД2.

Методы

Методы. Было привлечено в общей сложности 35 пациентов с СД2 (с СД2 без нейропатии – 15 и с СД2 с периферической полинейропатией – 20). Все участники были подвергнуты клинической и биохимической проверке, после чего три раза в неделю в течение 12 нед проделывали структурированную программу упражнений, получая при этом стандартную медицинскую помощь.

Результаты

Результаты. Средний возраст участников составил 56±10,5 (без нейропатии) и 62,3±7,35 (с нейропатией) года, средняя продолжительность диабета составила 8,7±8,95 (без нейропатии) и 10,97±8 (с нейропатией) года, средний индекс массы тела – 26,54±4,83 (без невропатии), 24,39±3,58 (с нейропатией). Значительные различия наблюдались в кинетических и кинематических показателях.

Заключение

Заключение. Настоящее исследование показывает, что протокол структурированных упражнений очень эффективен в улучшении биомеханики стопы у пациентов с СД2 как с нейропатией, так и без нее. Выполнение данных упражнений может корректировать структуру и функцию стопы и в конечном итоге может снизить риск развития диабетических язв.

Background

Background: The biomechanical changes in foot among people with type 2 diabetes mellitus often leads to various foot complications which could further add to diabetes related morbidity & mortality. These changes could be seen due to musculoskeletal factor like reduction in intrinsic foot muscle strength, tightness of lower limb muscles, postural changes, etc.

Aim

Aim: To design and determine the efficacy of a structured exercise program on foot kinetics and kinematics among type 2 participants

Materials and methods

Materials and methods: A total of 35 participants with type 2 diabetes (n=15, type 2 diabetes mellitus without neuropathy and n=20, type 2 diabetes with peripheral neuropathy) were recruited. All participants were screened clinically & biochemically and given a set of structured exercise program, three times a week for 12weeks along with standard medical care.

Results

Results: The mean age of the participants was 56±10.5 (Non neuropathy) 62.3±7.35 (Neuropathy) years, mean duration of diabetes was 8.7±8.95 (Non neuropathy), 10.97±8 (Neuropathy) years, mean Body mass index was 26.54± 4.83(Non neuropathy), 24.39±3.58 (Neuropathy), Significant differences have been observed in kinetic and kinematic variables.

Conclusion

Conclusion: The present study shows that the structured exercise protocol is very effective in improving the biomechanics of foot in people with type 2 diabetes with and without neuropathy. It could help to correct the structure and function of the foot and eventually could reduce the risk of foot complications like diabetic foot ulcers.

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The authors declare that there are no conflicts of interest present.