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运动对糖尿病周围神经病变患者肌肉骨骼功能及临床结局的有效性:一项系统评价和荟萃分析

Effectiveness of exercise on musculoskeletal function and clinical outcomes in patients with diabetic peripheral neuropathy: a systematic review and meta-analysis.

作者信息

Yang Jin, Li Li, Ye Ting, Pu You, Yao Qian, Luo Jian, Huang Yunman, Zhang Xianqin, Yang Zheng

机构信息

Department of Cardiology, Sichuan Mianyang 404 Hospital, Mianyang, China.

School of Nursing, Chengdu Medical College, Chengdu, China.

出版信息

Front Neurol. 2025 Aug 29;16:1610955. doi: 10.3389/fneur.2025.1610955. eCollection 2025.

Abstract

BACKGROUND

Diabetes mellitus is a major public health issue, and its complication, diabetic peripheral neuropathy (DPN), can significantly impair foot and ankle joint function, affecting daily activities and quality of life. This systematic review and meta-analysis aimed to evaluate the impact of exercise on musculoskeletal function and clinical outcomes in DPN patients.

METHODS

Evaluation of randomized controlled trials (RCTs) of exercise in patients with DPN published from Cochrane Library, PubMed, Embase, Web of Science, Medline, ClinicalKey, CNKI, Wanfang database, VIP Chinese Journal Database, and Chinese Biomedical Literature Database was performed. Revman 5.4 software was used for statistical analysis.

RESULTS

A total of 625 samples were included in 10 studies. It showed that exercise significantly increased ankle dorsiflexion range of motion (SMD = 0.61, 95%CI (0.13, 1.08), < 0.05), ankle flexion range of motion (SMD = 0.59, 95% CI (0.12, 1.06), < 0.05), hallux strength (MD = 1.89, 95% CI (1.00, 2.78), < 0.001), toes strength (MD = 2.51, 95% CI (1.69, 3.33), < 0.001) and lower extremity functional strength (MD = -2.82, 95% CI (-3.88, -1.76), < 0.001), whereas reduced glycosylated hemoglobin (SMD = -1.44, 95% CI (-2.30, -0.57), < 0.01) and body mass index (MD = -0.86, 95% CI (-1.15, -0.57), < 0.001). However, discrepancies were observed between pooled results based on different neuropathy assessment tools.

CONCLUSION

The available evidence suggests that exercise training is an effective method for improving peripheral neuropathy.

SYSTEMATIC REVIEW REGISTRATION

https://inplasy.com/, identifier INPLASY202340112.

摘要

背景

糖尿病是一个重大的公共卫生问题,其并发症糖尿病周围神经病变(DPN)会显著损害足踝关节功能,影响日常活动和生活质量。本系统评价和荟萃分析旨在评估运动对DPN患者肌肉骨骼功能和临床结局的影响。

方法

对来自Cochrane图书馆、PubMed、Embase、科学网、Medline、ClinicalKey、中国知网、万方数据库、维普中文期刊数据库和中国生物医学文献数据库中发表的关于DPN患者运动的随机对照试验(RCT)进行评价。使用Revman 5.4软件进行统计分析。

结果

10项研究共纳入625个样本。结果显示,运动显著增加了踝关节背屈活动度(标准化均数差[SMD]=0.61,95%可信区间[CI](0.13, 1.08),P<0.05)、踝关节屈曲活动度(SMD=0.59,95%CI(0.12, 1.06),P<0.05)、拇趾力量(平均差[MD]=1.89,95%CI(1.00, 2.78),P<0.001)、脚趾力量(MD=2.51,95%CI(1.69, 3.33),P<0.001)和下肢功能力量(MD=-2.82,95%CI(-3.88, -1.76),P<0.001),而糖化血红蛋白降低(SMD=-1.44,95%CI(-2.30, -0.57),P<0.01)和体重指数降低(MD=-0.86,95%CI(-1.15, -0.57),P<0.001)。然而,基于不同神经病变评估工具的汇总结果之间存在差异。

结论

现有证据表明,运动训练是改善周围神经病变的有效方法。

系统评价注册

https://inplasy.com/,标识符INPLASY202340112。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c2b/12425781/60275504364b/fneur-16-1610955-g0001.jpg

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