Investigation of the Immediate Effects of Whole Body Vibration Training on Balance, Dual Task and Gait in Individuals with Diabetic Neuropathy
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- Balance Performance
研究概览
简要总结
Overview of Diabetes and Its Complications:
- Diabetes is a chronic health issue that can lead to various complications, affecting human health negatively. One of these complications is diabetic peripheral neuropathy (DPN), which results from hyperglycemia and affects peripheral nerves. This can lead to sensory loss, motor dysfunction, and ultimately, disability.
- The complications from diabetes can result in the loss of function and disability, affecting various systems, including the nervous system (e.g., retinopathy, neuropathy, and atherosclerosis).
Peripheral Neuropathy in Diabetes:
- DPN occurs due to damage to peripheral nerves caused by hyperglycemia. Over time, it affects the small unmyelinated fibers responsible for pain and temperature sensations, leading to axonal degeneration and demyelination, causing sensory loss.
- In later stages, motor dysfunction can also occur, impacting intrinsic foot muscles, leading to muscle weakness and atrophy.
Whole Body Vibration (WBV) Therapy:
- WBV is a therapeutic method that uses mechanical vibrations from a vibrating platform to stimulate muscle contractions. It is being researched for its effects on managing diabetic neuropathy and related complications.
- Studies have shown that WBV can improve balance, functional independence, and postural stability in patients with diabetes, potentially serving as an alternative or complement to traditional balance exercises.
- A randomized controlled trial compared the effects of WBV and Tai Chi on postural balance and found that WBV was more effective in promoting functional independence and balance.
Impact on Sensory Function and Balance:
- As DPN progresses, sensory loss may prevent patients from noticing injuries, which could lead to severe complications. A study conducted in 2017 showed that WBV improved vibration perception thresholds (VPT) in patients with type 2 diabetes and peripheral neuropathy, indicating improved sensory function, which is crucial for maintaining balance and walking.
- This improvement is thought to be linked to increased blood circulation in peripheral tissues and improved glucose levels due to WBV therapy.
Dual Task Performance and WBV:
- Dual-task performance, which involves performing cognitive and motor tasks simultaneously, is typically impaired in patients with diabetic neuropathy, leading to difficulties in daily activities. WBV has shown potential in improving muscle strength and balance, which could enhance patients' ability to perform dual tasks more effectively.
Research Findings:
- Several studies have demonstrated that WBV training can significantly improve both static and dynamic balance in patients with diabetic neuropathy. Given that balance issues are common in these patients and contribute to a higher risk of falls, these improvements are particularly important.
- The literature emphasizes the need for continued research to clarify the physiological mechanisms behind WBV's effects on sensory feedback mechanisms, which are essential for postural control.
Need for Further Research:
- Despite promising findings, some studies have pointed out the need for more research to validate the clinical efficacy of WBV for managing chronic complications like neuropathic pain and improving quality of life in diabetic patients.
- There is a need for better-designed studies to confirm the long-term benefits of WBV training in diabetic patients and to develop standardized protocols for its use.
Proposed Study:
- A planned study aims to investigate the immediate effects of WBV on balance, dual-task performance, and walking in individuals with type 2 diabetes and peripheral neuropathy. The study will include 40 patients who meet specific inclusion criteria, with participants randomized into two groups (WBV training group and control group).
- Data will be collected on participants' balance performance (using the Timed Up and Go test), dual-task performance (using a dual-task cost formula), and walking features (using the 1-minute walk test). The results will be analyzed using SPSS software.
Methodology:
- The study will use random assignment and include a control group to evaluate the immediate effects of WBV. Data collection will include assessments of balance, dual-task performance, and walking capabilities before and after WBV treatment.
详细描述
Sure! Here's a more detailed and extended version of the summary:
Diabetes is a chronic health condition that can lead to various complications, affecting many aspects of human health. One of the significant complications resulting from diabetes is peripheral neuropathy, which is caused by hyperglycemia-induced damage to peripheral nerves. Over time, this condition results in axonal degeneration and demyelination, particularly affecting small unmyelinated fibers responsible for pain and temperature sensation, leading to sensory loss. In advanced stages, it can result in motor dysfunction, which particularly affects intrinsic foot muscles, leading to muscle weakness and atrophy. Peripheral neuropathy can significantly impair balance, dual-task performance, and gait, all of which are crucial for maintaining functional independence and mobility in diabetic patients.
The effect of Whole Body Vibration (WBV) training on these aspects has been an emerging research area. WBV, which uses mechanical vibrations produced by a vibrating platform to stimulate muscle contractions, has shown potential benefits in improving balance, dual-task performance, and gait in individuals with diabetic neuropathy. Several studies have suggested that WBV can serve as a complementary or superior alternative to traditional balance training exercises. For instance, a randomized controlled trial comparing WBV and Tai Chi in diabetic patients found that WBV was more effective than Tai Chi in promoting functional independence and improving balance.
In patients with diabetic peripheral neuropathy (DPN), sensory loss may prevent them from recognizing injuries, leading to severe complications. A study from 2017 explored the impact of WBV on vibration perception thresholds (VPT) in patients with type 2 diabetes and peripheral neuropathy, finding significant improvements in VPT, which indicated enhanced sensory function, critical for maintaining balance and gait. This improvement was attributed to increased blood circulation in peripheral tissues and better glucose control, which positively influenced sensory feedback mechanisms crucial for postural control.
Moreover, WBV has been shown to improve both static and dynamic balance in individuals with DPN, which is vital for reducing fall risks in these patients. The improvements in balance are believed to result from muscle contraction stimulation and the proprioceptive feedback provided by the vibrations. Furthermore, dual-task performance, which is often impaired in patients with DPN due to the difficulty of performing cognitive and motor tasks simultaneously, might also improve with WBV. This improvement could help patients perform better in daily activities that require multitasking, such as walking while engaging in cognitive tasks.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
盲法说明
In this study, no formal masking (blinding) is applied, as the nature of the intervention (whole-body vibration) makes it challenging to conceal from participants and assessors. However, alternative approaches to minimizing bias are considered.
Masking in the Study Participants: Not masked. Since WBV is a physical intervention, participants are aware they are receiving treatment, making blinding impossible.
Researchers Conducting the Intervention: Not masked. The investigators administering WBV are aware of the intervention settings and participant exposure.
Outcome Assessors (If Different from Researchers): Not masked. The same researchers conducting the intervention may also conduct pre- and post-tests, increasing the potential for observer bias.
Data Analysts: Potential for masking. If feasible, data analysis could be conducted by an independent researcher blinded to the intervention phase (pre- or post-WBV) to reduce bias in interpreting results.
入排标准
- 年龄范围
- 40 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Type 2 diabetes patients aged 40-75 years,
- •Having a score of 13-29 on the Michigan Questionnaire (intermediate level),
- •Having a Mini Mental Test score of 24 and above,
- •Having an HbA1C <8.5%, having controlled blood glucose levels in the last three months,
- •Being able to walk independently
- •Volunteering to participate in the study.
排除标准
- •Those with diabetic infected wounds,
- •Those with neurological diseases other than diabetic neuropathy,
- •Those with rheumatoid arthritis, vestibular system disorders, visual
- •Impairments, those with a history of trauma, injury and surgery,
- •Those with knee or hip replacement,
- •Those with a history of epilepsy and cognitive problems.
研究组 & 干预措施
Control Group
In the Control Group, balance assessment with the Timed Up and Go Test, evaluation of dual task performance with the Dual Task Cost Gap Formula, and gait assessment with the 1 Minute Walk Test will be performed.
Whole Body Vibration Training Group
For the Whole Body Vibration Training Group, balance, dual task performance and gait will be evaluated. These participants will be evaluated before and after 10 minutes of vibration application.
干预措施: The Whole Body Vibration (Device)
结局指标
主要结局
Balance Performance
时间窗: For the control group the test will be administered once at baseline and 10 minute later on the same day . In the vibration training group, it will be administered at Baseline (Before WBV) and Immediately After WBV (within 5 minutes).
Change in balance performance assessed using the Timed Up and Go (TUG) test. The test measures the time taken (in seconds) to rise from a chair, walk 3 meters, turn, and return to sit. Lower times indicate better balance and functional mobility.
Gait Performance
时间窗: For the control group (one-time assessment at baseline and 10 minutes later), For the WBV Training Group Baseline (Pre-WBV) and Immediately Post-WBV
Change in walking capacity measured by the 1-Minute Walk Test. Total distance walked (in meters) is recorded, with greater distances indicating better walking endurance and gait function.
次要结局
- Functional Mobility (Timed Up and Go Test - TUG)(Start (Before WBV) and Immediately After WBV (within 10 minutes))
- Cognitive-Motor Performance (Dual-Task Timed Up and Go Test - DT-TUG)(Start (Before WBV) and Immediately After WBV (within 5 minutes))
- Walking Capacity (1-Minute Walk Test)(Start (Before WBV) and Immediately After WBV (within 5 minutes))
研究者
Tezel Yıldırım Şahan
Associate Professor
Hacettepe University