The aim of the study is to investigate the effects of modified otago exercises on joint position sense, balance and physical fitness parameters in individuals with diabetic neuropathy. In addition aim of to examine the effects of exercise on metabolic variables and to gain exercise awareness in diabetic individuals.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
38
The exercise group will be informed about diabetes and diabetes complications. A total of 16 sessions of 8 weeks, modified otago exercises will be applied individually by the research physiotherapist.Individuals will be allowed to walk at a moderate pace for at least 30 minutes 5 days a week (home program).
The control group will be informed about diabetes and diabetes complications. Individuals will be allowed to walk at a moderate pace for at least 30 minutes 5 days a week (home program)
Karaman Provincial Health Directorate Karaman Training and Research Hospital
Karaman, Center, Turkey (Türkiye)
Blood Glucose Level
Routinely, the glycated hemoglobin (Hba1c) (mg/dL) level will be recorded in the blood laboratory results by the endocrinologist.
Time frame: Change from baseline at 8 weeks
Blood Cholesterol Level
Routinely, the cholesterol (mg/dL) level will be recorded in the blood laboratory results by the endocrinologist.
Time frame: Change from baseline at 8 weeks
Blood Triglycerides Level
Routinely, the triglycerides (mg/dL) level will be recorded in the blood laboratory results by the endocrinologist.
Time frame: Change from baseline at 8 weeks
Blood HDL Cholesterol Level
Routinely, the HDL cholesterol (mg/dL) level will be recorded in the blood laboratory results by the endocrinologist.
Time frame: Change from baseline at 8 weeks
Blood LDL Cholesterol Level
Routinely, the LDL cholesterol (mg/dL) level will be recorded in the blood laboratory results by the endocrinologist.
Time frame: Change from baseline at 8 weeks
Joint Position Sense Evaluation
Ankle joint position sense of 10 degrees dorsiflexion and 15 degrees plantar flexion target angles will be evaluated.
Time frame: Change from baseline at 8 weeks
The Timed Up & Go (Functional Mobility Assessment)
Patients sitting in a chair without armrests will be asked to stand up with the start command and walk the 3-meter distance, whose start and end points are specified before, turn around and sit on the chair again. The test will be repeated 3 times and the average time will be recorded.
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Time frame: Change from baseline at 8 weeks
Balance Evaluation
Balance Error Scoring System:Practices are performed on hard and soft ground separately in 3 positions, two feet, one foot and tandem stance, with eyes closed.After the test position is taught to the patient, the patient is asked to close their eyes and hold the position for 20 seconds.A mistake made for 20 seconds on each floor and position is recorded as 1 point.The maximum error score is 10.All assessments are made without shoes
Time frame: Change from baseline at 8 weeks
Body Mass İndex Evaluation
Body weight of the individual is recorded in kilograms and height in meters.Calculated by dividing body weight by the square of the height in meters (kg/m2)
Time frame: Change from baseline at 8 weeks
Body Weight
Calculated in kilograms (kg) with a Tanita BC730 brand scale
Time frame: Change from baseline at 8 weeks
Body Fat Percentage
Body fat percentage is calculated as percentage (%) with Tanita BC730 brand scale
Time frame: Change from baseline at 8 weeks
Lean Body Weight
Calculated in kilograms (kg) by subtracting body fat from body weight.
Time frame: Change from baseline at 8 weeks
Cardio-respiratory Fitness Evaluation
A distance of 30 meters is created in an area measuring 10x40 meters, the start and end points are marked.Patients are asked to walk on the designated line for 6 minutes at the highest speed they can walk without running.At the end of 6 minutes, the distance they have walked is recorded in meters.
Time frame: Change from baseline at 8 weeks
Sit and Reach Test (Flexibility ) Evaluation
The patient is asked to lie down without bending his knees towards the ruler placed on the flexibility table. Before the test, the patient is asked to reach forward 1-2 times and is taught what to do. Then the patient is asked to lie forward 3 times and the average of the data obtained is recorded in centimeters.
Time frame: Change from baseline at 8 weeks
Muscle Strength (30-second Chair Stand Test) Evaluation
Sitting in a standard chair without armrests, the patient is asked to cross his hands over his shoulder. With the start command, the stopwatch is kept and the patient is asked to stand up completely from the chair and sit down again. The number of repetitive movements for 30 seconds is recorded.
Time frame: Change from baseline at 8 weeks
Falling Risk
Fall Efficacy Scale International: It is a common test battery with 16 items that reveals the possibility of falling in patients.The higher the test score, the higher the probability of falling in the patient.
Time frame: Change from baseline at 8 weeks
Cognitive Status
Mini Mental Test will be used to evaluate the cognitive status of individuals. It is a short, useful, standardized test that provides the opportunity to evaluate cognitive performance in a short time. A high score indicates a good cognitive status. The maximum possible score is 30. A score of 17 and below is considered severe dementia, a score of 18-23 is considered mild dementia, and a score of 24-30 is considered normal.
Time frame: a day before the start of treatment
Neuropathic Pain Scale
Self-Leeds Assesment of Neuropathic Symptoms \& Signs Pain Score: It is a simple test used in the differential diagnosis of neuropathic pain at the bedside.A score of 12 and above is diagnostic for neuropathic pain
Time frame: Change from baseline at 8 weeks
Individual Exercise İntensity
Borg Scale: It is a method used to determine the exercise tolerance of the individual.The individual scores the fatigue she feels between 6-20.Fatigue level; nothing (6), very very light (7-8), very light (9-10), light (11-12), somewhat difficult (13-14), difficult (15-16), very difficult (17- 18), very very difficult (19), exhaustion (20)
Time frame: a day before the start of treatment
Monofilament Evaluation
The monofilament is touched to the relevant point on the foot until it takes a C shape. Absence of a 4.17 or thicker monofilament is interpreted as being compatible with neuropathy.Failure to detect a 5.07 monofilament is considered as a loss of protective sensation.
Time frame: a day before the start of treatment
Diaposan (Vibration) Evaluation
A 128 Hz tuning fork, which was oscillated before, is placed on the metatarsophalangeal joint of both feet of the individual and the patient is asked to feel the vibration. If the investigator still perceives the vibration as soon as the patient says he does not feel the vibration, it is considered neuropathy.
Time frame: a day before the start of treatment