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The gait and balance of patients with diabetes can be improved: a randomised controlled trial

Allet, L. ; Armand, S. ; de Bie, R. ; Golay, A. ; Monnin, D. ; Aminian, K. ; Staal, J. ; de Bruin, E.

In: Diabetologia, 2010, vol. 53, no. 3, p. 458-466

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    Titre
    • The gait and balance of patients with diabetes can be improved: a randomised controlled trial
    Auteur
    • Allet, L.. Department of Epidemiology, Maastricht University and Caphri Research School, Maastricht, the Netherlands
    • Armand, S.. Willy Taillard Laboratory of Kinesiology, Geneva University Hospital and University of Geneva, Geneva, Switzerland
    • de Bie, R.. Department of Epidemiology, Maastricht University and Caphri Research School, Maastricht, the Netherlands
    • Golay, A.. Service of Therapeutic Education for Chronic Diseases, WHO Collaborating Center, Geneva University Hospital and University of Geneva, Geneva, Switzerland
    • Monnin, D.. Care Services Directorate, Unit of Physiotherapy Research and Quality Assurance, Geneva University Hospital and University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland
    • Aminian, K.. Laboratory of Movement Analysis and Measurement, EPFL, Lausanne, Switzerland
    • Staal, J.. Department of Epidemiology, Maastricht University and Caphri Research School, Maastricht, the Netherlands
    • de Bruin, E.. Institute of Human Movement Sciences and Sport, ETH, Zürich, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:312722
    Summary
    Aims/hypothesis: Gait characteristics and balance are altered in diabetic patients. Little is known about possible treatment strategies. This study evaluates the effect of a specific training programme on gait and balance of diabetic patients. Methods: This was a randomised controlled trial (n = 71) with an intervention (n = 35) and control group (n = 36). The intervention consisted of physiotherapeutic group training including gait and balance exercises with function-orientated strengthening (twice weekly over 12weeks). Controls received no treatment. Individuals were allocated to the groups in a central office. Gait, balance, fear of falls, muscle strength and joint mobility were measured at baseline, after intervention and at 6-month follow-up. Results: The trial is closed to recruitment and follow-up. After training, the intervention group increased habitual walking speed by 0.149m/s (p < 0.001) compared with the control group. Patients in the intervention group also significantly improved their balance (time to walk over a beam, balance index recorded on Biodex balance system), their performance-oriented mobility, their degree of concern about falling, their hip and ankle plantar flexor strength, and their hip flexion mobility compared with the control group. After 6months, all these variables remained significant except for the Biodex sway index and ankle plantar flexor strength. Two patients developed pain in their Achilles tendon: the progression for two related exercises was slowed down. Conclusions/interpretation: Specific training can improve gait speed, balance, muscle strength and joint mobility in diabetic patients. Further studies are needed to explore the influence of these improvements on the number of reported falls, patients' physical activity levels and quality of life. Trial registration:: ClinicalTrials.gov NCT00637546 Funding:: This work was supported by the Swiss National Foundation (SNF): PBSKP-123446/1