strength training in patients with diabetic neuropathy: acute responses and long term adaptations...

Strength training in patients with diabetic neuropathy: Acute

responses and long term adaptations

Robert van Deursen1, Alejandro Meana-Esteban1, Patricia Price2 and Keith Harding2

1Research Centre for Clinical Kinaesiology2Wound Healing Research Unit

Overview

• Background – Neuropathy– Strength training

• Study aims• Methodology

– Study design– Methods– Intervention

Introduction: Diabetes• Definition: Metabolic disorder resulting in

abnormally high blood sugar levels

Damaged Nerves

NEUROPATHY

Type I

Type II

Introduction: Neuropathy

1. Walking – Neuropathy– Muscular weakness– Reduced ROM

2. Poor circulation

High foot pressures Tissue damage

ULCERSULCERS

Why strength training in neuropathic patients?

• Why neuropathic patients– PA neuropathic patients = ???

• Why strength training– PA guidelines– Strength training improves glycemic control– Muscle weakness– ST diabetic patients= ???

Aims• To determine whether and to what extent ST

has a positive effect in:– Gait characteristics (ROM, foot pressures,

EMG)

– Circulation• Micro-circulation (Blood flow)

Study design

Baseline study Interventional study

HEALTH

DN

80

40

EX= 40

CON= 40

T1

T2

Pre- intervention Post- interventionINTERVENTION (16 weeks)

120

Methods• Gait characteristics

– Foot pressure: Pressure distribution platform– Muscular activities: EMG– ROM: Electrogiometers

Methods• Circulation

– Micro-circulation: Near infrared spectroscopy

VO rest Exercise Protocol VO Post- Exec

Intervention• 4 times per week throughout 16 weeks

– 2 gym- based sessions (1 h)• 2-3 sets of 8-10 rep (60-80% 1RM)• Flexibility

– 2 home- based sessions (30min)• ROM

THANK YOU VERY MUCH FOR YOUR ATTENTION!!!!!!!!