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Published in: Sports Medicine 9/2014

01-09-2014 | Systematic Review

Exercise Intervention Studies in Patients with Peripheral Neuropathy: A Systematic Review

Authors: Fiona Streckmann, Eva M. Zopf, Helmar C. Lehmann, Kathrin May, Julia Rizza, Philipp Zimmer, Albert Gollhofer, Wilhelm Bloch, Freerk T. Baumann

Published in: Sports Medicine | Issue 9/2014

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Abstract

Introduction

Peripheral neuropathies (PNPs) encompass a large group of disorders of heterogeneous origin which can manifest themselves with sensory and/or motor deficits depending on the predominantly affected nerve fiber modality. It represents a highly prevalent disease group which can be associated with significant disability and poor recovery. Exercise has the potential to improve side effects of PNP.

Objective

Our objective in this systematic review was to analyze exercise interventions for neuropathic patients in order to evaluate the possible benefits of exercise.

Methods

Three independent reviewers used PubMed, MEDPILOT® (MEDLINE), Cochrane, and relevant reference lists to obtain the data. Relevant studies were graded according to the Oxford Levels of Evidence.

Results

Eighteen studies (ten randomized controlled trials and eight controlled clinical trials) met all inclusion criteria. Three (diabetic) studies were ranked very high quality [1b (A)], nine high quality (four diabetes, one cancer, four others) [2b (B)], while six (four diabetes, two others) showed low quality (4/C). Current data suggests that exercise is a feasible, safe, and promising supportive measure for neuropathic patients. This is best documented for patients with diabetic peripheral neuropathy (DPN), suggesting that endurance training has the potential to prevent the onset of and reduce the progression of DPN. In general, balance exercises showed the highest effect on the motor as well as sensory symptoms in all types of PNP.

Conclusion

Overall, balance training appears to be the most effective exercise intervention. Studies focusing exclusively on strength, or a combination of endurance and strength, appear to have a lower impact. For metabolically-induced neuropathies, endurance training also plays an important role. Further research with high methodological quality needs to be conducted in order to establish evidence-based clinical recommendations for neuropathic patients.
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Metadata
Title
Exercise Intervention Studies in Patients with Peripheral Neuropathy: A Systematic Review
Authors
Fiona Streckmann
Eva M. Zopf
Helmar C. Lehmann
Kathrin May
Julia Rizza
Philipp Zimmer
Albert Gollhofer
Wilhelm Bloch
Freerk T. Baumann
Publication date
01-09-2014
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 9/2014
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-014-0207-5

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