This study aimed to examine whether physiotherapy interventions could prevent lower extremity muscle strength weakness in older type 2 diabetic patients with DPN.
This study used data from our previous studies [Kataoka H, Nomura T, et al. J Phys Fitness Sports Med, 2020]. The study cohort of older type 2 diabetic patients included 21 participants with DPN (15 females, 71.3±5.5 years of age, 23.2±3.0 kg/m2, HbA1c 9.5±2.9%) and 18 participants without DPN (6 females, 77.0±5.2 years old, 23.1±3.4 kg/m2, HbA1c 9.4±2.3%). The characteristics of the groups did not significantly differ. The lower extremity muscle strength was measured using the maximum isometric knee extension force (KEF). The absolute value of the isometric KEF (N) multiplied by the moment arm (m) was used to calculate KEF (Nm). The relative KEF (Nm/kg) was calculated by dividing KEF (Nm) by body weight (kg) and was subsequently used in the analyses. In all participants, after receiving instructions for performing the exercises, tele-guidance for physiotherapy will be contacted by phone or e-mail once/week for 6-months. Approximately, 25 interventions were scheduled for each patient by the end of the study period.
In patients without DPN, KEF significantly improved from 1.24±0.56 Nm/kg from 1.40±0.52 Nm/kg (P0.01). On the other hands, KEF did not change from 1.27±0.48 Nm/kg to 1.26±0.56 Nm/kg (P=0.84) in patients with DPN.
Physiotherapy intervention was effective in improving KEF in older type 2 diabetic patients without DPN; in addition, physiotherapy interventions may be effective in preventing KEF in older type 2 diabetic patients with DPN. However, this study included a small number of participants and attention was necessary for interpretation.
Physiotherapy intervention for KEF weakness is less effective in older type 2 diabetic patients with DPN than in those without DPN. Therefore, DPN development should be closely monitored,and more intensive physiotherapy protocols should be considered for patients with DPN.
frailty
older people
