From treatment to preventive actions: improving function in patients with diabetic polyneuropathy

From treatment to preventive actions: improving function in patients with diabetic polyneuropathy

Author Sacco, Isabel C. N. Google Scholar
Sartor, Cristina D. Autor UNIFESP Google Scholar
Abstract Diabetic polyneuropathy is an insidious and long-term complication of this disease. Synergistic treatments and preventive actions are crucial because there are no clear boundaries for determining when health professionals should intervene or what intervention would best avoid the consequences of neuropathy. Until now, most therapies to any diabetic individual were applied only after the patient's limb was ulcerated or amputated. The loss of muscle and joint functions is recognized as the main cause of plantar overloading. However, if foot and ankle exercises are performed following the early diagnosis of diabetes, they can enable the patient to maintain sufficient residual function to interact with the environment. This article summarizes the current knowledge about the musculoskeletal deficits and biomechanical alterations caused by neuropathy. It also describes the potential benefits of foot and ankle exercises for any diabetic patient that is not undergoing the plantar ulcer healing process. We concentrate on the prevention of the long-term deficits of neuropathy. We also discuss the main strategies and protocols of therapeutic exercises for joints and muscles with deficits, which are applicable to all diabetic patients with mild to moderate neuropathy. We describe further efforts in exploiting the applicability of assistive technologies to improve the adherence to an exercise program. Following the contemporary trends towards self-monitoring and self-care, we developed a software to monitor and promote personalized exercises with the aim of improving autonomous performance in daily living tasks. Initiatives to prevent the complications of functional diabetes are highly recommended before it is too late for the patient and there is no longer an opportunity to reverse the tragic consequences of neuropathy progression. Copyright (c) 2016 John Wiley & Sons, Ltd.
Keywords Diabetic Foot
Therapeutic Exercises
Foot
Biomechanics
Preventive Care
RehabilitationRandomized Controlled-Trial
Limited Joint Mobility
Intrinsic Muscle Atrophy
Custom-Made Footwear
Peripheral Neuropathy
Plantar Pressures
Gait Characteristics
Weight-Bearing
Toe Deformity
Individuals
Language English
Sponsor Sao Paulo Research Foundation [FAPESP 2011/19304-4, 2013/05580-5]
National Council for Scientific and Technological Development [CNPq 151531/2013-7]
Grant number FAPESP: 2011/19304-4
FAPESP: 2013/05580-5
CNPq: 151531/2013-7
Date 2016
Published in Diabetes-Metabolism Research And Reviews. Hoboken, v. 32, n. 1, p. 206-212, 2016.
ISSN 1520-7560 (Sherpa/Romeo, impact factor)
Publisher Wiley-blackwell
Extent 206-212
Origin https://doi.org/10.1002/dmrr.2737
Access rights Open access Open Access
Type Article
Conference paper
Web of Science ID WOS:000369134100021
URI http://repositorio.unifesp.br/handle/11600/49624

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