Effect of lower body positive pressure aerobic training on fall risk in patients with diabetic polyneuropathy. Randomized controlled trial.

Abstract

BACKGROUND\nRetarded task-oriented gait, balance performance and increased fall risk are among the most debilitating problems in patients with diabetic polyneuropathy (DPN). The lower body positive pressure (LBPP) training was recently introduced in the field of rehabilitation, but evaluating the effects of the LBPP on gait, balance and fall risk in patients with DPN has not been throughly investigated.\n\n\nAIM\nTo evaluate the effect of LBPP treadmill training program on task-oriented gait, balance performance and fall risk in patients with DPN.\n\n\nDESIGN\nSingle-blinded, randomized-controlled trial.\n\n\nSETTING\nRehabilitative outpatient unit.\n\n\nPOPULATION\nSixty-Two patients with DPN were randomly assigned into 5-groups; group-A (100% weight-bearing; n=12), group-B (75% weight-bearing; n=13), group-C (50% weight-bearing; n=13), group-D (25% weight-bearing; n=12) and group-E (control group; n=12).\n\n\nMETHODS\nThe intervention groups (A, B, C, D) received moderate intensity aerobic exercise training (AET) program (30-45 minutes, 50-70% heart rate reserve) on the AlterG treadmill for 12-weeks. Task-oriented gait, balance performance and the fall risk were evaluated at baseline (evaluation-1), after 12-weeks (evaluation-2) and 12-weeks post-study cessation (evaluation-3; follow-up) for all groups using the Tinetti balance assessment tool.\n\n\nRESULTS\nAt evaluation-2; there were significant within-groups increases in the balance, gait and fall risk scores. There were significant between-groups differences in the same evaluated variables, with the highest increases were in group-B (P<0.05). At evaluation-3; there was a decline in the mean values of the evaluated variables, but still significant increases in the mean values of balance, gait and fall risk compared to the baseline mean values. There were significant between-groups differences in all variables, with the highest increases were in group-B (P<0.05).\n\n\nCONCLUSIONS\nModerate intensity LBPP treadmill training program can effectively improve taskoriented gait, balance performance, and fall risk scores in patients with DPN. The 25% off-loading weight percentage during the LBPP treadmill training program yielded the most favorable short and long-term improvements compared to the other weight off-loading percentages in patients with DPN.\n\n\nCLINICAL REHABILITATION IMPACT\nThe LBPP aerobic training program is an effective rehabilitation procedure in patients with DPN especially when utilizing the 25% off-loading weight percentage during the LBPP treadmill training program.