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Combined exercise and visual gaze training improves stepping accuracy in people with diabetic peripheral neuropathy

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  • J.C. Handsaker
  • S.J. Brown
  • M. Petrovic
  • F.L. Bowling
  • S. Rajbhandari
  • D.E. Marple-Horvat
  • A.J.M. Boulton
  • N.D. Reeves
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Article number107404
<mark>Journal publication date</mark>31/10/2019
<mark>Journal</mark>Journal of Diabetes and its Complications
Issue number10
Volume33
Publication StatusPublished
Early online date6/09/19
<mark>Original language</mark>English

Abstract

Introduction: Patients with diabetes and diabetic peripheral neuropathy (DPN) place their feet with less accuracy whilst walking, which may contribute to the increased falls-risk. This study examines the effects of a multi-faceted intervention on stepping accuracy, in patients with diabetes and DPN. Methods: Forty participants began the study, of which 29 completed both the pre and post-intervention tests, 8 patients with DPN, 11 patients with diabetes but no neuropathy (D) and 10 healthy controls (C). Accuracy of stepping was measured pre- and post-intervention as participants walked along an irregularly arranged stepping walkway. Participants attended a one-hour session, once a week, for sixteen weeks, involving high-load resistance exercise and visual-motor training. Results: Patients who took part in the intervention improved stepping accuracy (DPN: +45%; D: +36%) (p < 0.05). The diabetic non-intervention (D-NI) group did not display any significant differences in stepping accuracy pre- to post- the intervention period (−7%). Discussion: The improved stepping accuracy observed in patients with diabetes and DPN as a result of this novel intervention, may contribute towards reducing falls-risk. This multi-faceted intervention presents promise for improving the general mobility and safety of patients during walking and could be considered for inclusion as part of clinical treatment programmes.