Karolina S Khan1,2, Kristian Overgaard3, Hatice Tankisi4,5, Pall Karlsson6,7, Louise Devantier8, Søren Gregersen9, Troels S Jensen10,4,6, Nanna B Finnerup10,4,6, Rodica Pop-Busui11, Ulrik Dalgas3, Henning Andersen10,4. 1. Department of Neurology, Aarhus University Hospital, Aarhus, Denmark. kasnop@rm.dk. 2. International Diabetic Neuropathy Consortium, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark. kasnop@rm.dk. 3. Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark. 4. International Diabetic Neuropathy Consortium, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark. 5. Department of Clinical Neurophysiology, Aarhus University, Aarhus, Denmark. 6. Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. 7. Core Centre for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. 8. Department of Oto-Rhino-Laryngology, Regional Hospital West Jutland, Holstebro, Denmark. 9. Steno Diabetes Center Aarhus, Aarhus, Denmark. 10. Department of Neurology, Aarhus University Hospital, Aarhus, Denmark. 11. Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Abstract
AIMS/HYPOTHESIS: The aim of this study was to evaluate the effects of progressive resistance training (PRT) on muscle strength, intraepidermal nerve fibre density (IENFD) and motor function in individuals with type 2 diabetic polyneuropathy (DPN) and to compare potential adaptations to those of individuals with type 2 diabetes without DPN and healthy controls. METHODS: This was an assessor-blinded trial conducted at the Neurology department, Aarhus University Hospital. Adults with type 2 diabetes, with and without DPN and healthy control participants were randomised to either supervised PRT or non-PRT for 12 weeks. Allocation was concealed by a central office unrelated to the study. The co-primary outcomes were muscle strength in terms of the peak torque of the knee and ankle extensors and flexors, and IENFD. Secondary outcome measures included the 6 min walk test (6MWT), five-time sit-to-stand test (FTSST) and postural stability index obtained by static posturography. RESULTS: A total of 109 individuals were enrolled in three groups (type 2 diabetes with DPN [n = 42], type 2 diabetes without DPN [n = 32] and healthy control [n = 35]). PRT resulted in muscle strength gains of the knee extensors and flexors in all three groups using comparative analysis (DPN group, PRT 10.3 ± 9.6 Nm vs non-PRT -0.4 ± 8.2 Nm; non-DPN group, PRT 7.5 ± 5.8 Nm vs non-PRT 0.6 ± 8.8 Nm; healthy control group, PRT 6.3 ± 9.0 Nm vs non-PRT -0.4 ± 8.4 Nm; p<0.05, respectively). Following PRT the DPN group improved the 6MWT (PRT 34.6 ± 40.9 m vs non-PRT 2.7 ± 19.6 m; p=0.001) and the FTSST (PRT -1.5 ± 2.2 s vs non-PRT 1.5 ± 4.6 s; p=0.02). There was no change in IENFD following PRT in any of the groups. CONCLUSIONS/ INTERPRETATION: PRT improved muscle strength of the knee extensors and flexors and motor function in individuals with type 2 diabetic polyneuropathy at levels comparable with those seen in individuals with diabetes without DPN and healthy control individuals, while no effects were observed in IENFD. TRIAL REGISTRATION: ClinicalTrials.gov NCT03252132 FUNDING: Research reported in this paper is part of the International Diabetic Neuropathy Consortium (IDNC) research programme, supported by a Novo Nordisk Foundation Challenge Program grant (grant no. NNF14OC0011633) and Aarhus University.
AIMS/HYPOTHESIS: The aim of this study was to evaluate the effects of progressive resistance training (PRT) on muscle strength, intraepidermal nerve fibre density (IENFD) and motor function in individuals with type 2 diabetic polyneuropathy (DPN) and to compare potential adaptations to those of individuals with type 2 diabetes without DPN and healthy controls. METHODS: This was an assessor-blinded trial conducted at the Neurology department, Aarhus University Hospital. Adults with type 2 diabetes, with and without DPN and healthy control participants were randomised to either supervised PRT or non-PRT for 12 weeks. Allocation was concealed by a central office unrelated to the study. The co-primary outcomes were muscle strength in terms of the peak torque of the knee and ankle extensors and flexors, and IENFD. Secondary outcome measures included the 6 min walk test (6MWT), five-time sit-to-stand test (FTSST) and postural stability index obtained by static posturography. RESULTS: A total of 109 individuals were enrolled in three groups (type 2 diabetes with DPN [n = 42], type 2 diabetes without DPN [n = 32] and healthy control [n = 35]). PRT resulted in muscle strength gains of the knee extensors and flexors in all three groups using comparative analysis (DPN group, PRT 10.3 ± 9.6 Nm vs non-PRT -0.4 ± 8.2 Nm; non-DPN group, PRT 7.5 ± 5.8 Nm vs non-PRT 0.6 ± 8.8 Nm; healthy control group, PRT 6.3 ± 9.0 Nm vs non-PRT -0.4 ± 8.4 Nm; p<0.05, respectively). Following PRT the DPN group improved the 6MWT (PRT 34.6 ± 40.9 m vs non-PRT 2.7 ± 19.6 m; p=0.001) and the FTSST (PRT -1.5 ± 2.2 s vs non-PRT 1.5 ± 4.6 s; p=0.02). There was no change in IENFD following PRT in any of the groups. CONCLUSIONS/ INTERPRETATION: PRT improved muscle strength of the knee extensors and flexors and motor function in individuals with type 2 diabetic polyneuropathy at levels comparable with those seen in individuals with diabetes without DPN and healthy control individuals, while no effects were observed in IENFD. TRIAL REGISTRATION: ClinicalTrials.gov NCT03252132 FUNDING: Research reported in this paper is part of the International Diabetic Neuropathy Consortium (IDNC) research programme, supported by a Novo Nordisk Foundation Challenge Program grant (grant no. NNF14OC0011633) and Aarhus University.
Authors: Michael J Mueller; Lori J Tuttle; Joseph W Lemaster; Michael J Strube; Janet B McGill; Mary K Hastings; David R Sinacore Journal: Arch Phys Med Rehabil Date: 2012-12-28 Impact factor: 3.966
Authors: Fiona Streckmann; Eva M Zopf; Helmar C Lehmann; Kathrin May; Julia Rizza; Philipp Zimmer; Albert Gollhofer; Wilhelm Bloch; Freerk T Baumann Journal: Sports Med Date: 2014-09 Impact factor: 11.136
Authors: S F E Praet; R A M Jonkers; G Schep; C D A Stehouwer; H Kuipers; H A Keizer; L J van Loon Journal: Eur J Endocrinol Date: 2008-02 Impact factor: 6.664
Authors: Rodica Pop-Busui; Andrew J M Boulton; Eva L Feldman; Vera Bril; Roy Freeman; Rayaz A Malik; Jay M Sosenko; Dan Ziegler Journal: Diabetes Care Date: 2017-01 Impact factor: 19.112
Authors: L Allet; S Armand; R A de Bie; A Golay; D Monnin; K Aminian; J B Staal; E D de Bruin Journal: Diabetologia Date: 2009-11-17 Impact factor: 10.122