UNASSIGNED: To provide a synthesis of the literature regarding the effectiveness of physical rehabilitation interventions to improve balance in people with diabetic peripheral neuropathy who are at risk of falling.
UNASSIGNED: Four databases (PubMed, Embase, the Cochrane Central Register of Controlled Trials, Cumulated Index in Nursing and Allied Health Literature) were systematically searched from inception to July 2022. Articles meeting the eligibility criteria (ie, participants with diabetic peripheral neuropathy and at risk of falling based on validated fall balance outcome risk cut off scores; inclusion of physical rehabilitation intervention) underwent a quality assessment using the Physiotherapy Evidence Database scale. Data regarding fall risk was extracted.
UNASSIGNED: Sixteen studies met the eligibility criteria. Participants in six studies improved balance such that their fall risk was reduced from a moderate-high risk of falls to no or low risk of falls from pre- to post-intervention. Interventions within these six studies were variable and included balance exercise, gait training, endurance, tai-chi with mental imagery, proprioceptive training, aerobic training, and yoga. Participants in seven of the remaining studies showed no improvement and participants in three studies showed mixed results regarding improved balance and reduced fall risk status by post-intervention.
UNASSIGNED: While physical rehabilitation is sufficient to improve balance in individuals with diabetic peripheral neuropathy who are at risk of falling, few interventions led to improved balance and reduced fall risk. Interventions involving intentional weight shifting, manipulation of the base of support, and displacement of the center of mass such as tai-chi and yoga appear to provide the most consistent results in terms of decreasing fall risk. To better understand the effectiveness of rehabilitation on balance and fall risk, future studies should examine the impact of physical interventions on prospective fall rates.
■对有跌倒风险的糖尿病周围神经病变患者进行物理康复干预以改善平衡的有效性的文献进行综述。
■四个数据库(PubMed,Embase,Cochrane中央受控试验登记册,护理和相关健康文献的累积指数)从开始到2022年7月进行了系统搜索。符合资格标准的文章(即,根据验证的跌倒平衡结局风险截止评分,患有糖尿病周围神经病变且有跌倒风险的参与者;纳入物理康复干预)使用物理治疗证据数据库量表进行质量评估.提取了有关跌倒风险的数据。
■16项研究符合资格标准。六项研究的参与者改善了平衡,因此从干预前后,他们的跌倒风险从中度高跌倒风险降低到无跌倒风险或低跌倒风险。这六项研究中的干预措施是可变的,包括平衡运动,步态训练,耐力,带有心理意象的太极拳,本体感受训练,有氧训练,还有瑜伽.其余七项研究的参与者没有表现出改善,三项研究的参与者在干预后改善平衡和降低跌倒风险状态方面表现出不同的结果。
虽然身体康复足以改善有跌倒风险的糖尿病周围神经病变患者的平衡,很少的干预措施导致平衡改善和跌倒风险降低.涉及故意转移重量的干预措施,操纵支撑的基础,和重心的位移,如太极拳和瑜伽似乎提供了最一致的结果,在降低跌倒风险方面。为了更好地了解康复对平衡和跌倒风险的有效性,未来的研究应该研究身体干预对预期跌倒率的影响.