Abstract:

Objective To evaluate the effect of combining exercise training in balance function of patients with diabetic peripheral neuropathy (DPN). Methods A systematic search of Chinese Biomedical Literature Database (CBM),Chinese Knowledge Infrastructure (CNKI),WanFang Database,VIP,PubMed,Embase,Scopus,Web of Science and Cochrane Library were carried out to identify randomized control trials (RCTs) about the effect of exercise training in balance function of patients with diabetic peripheral neuropathy from inception to August 2020. Literature screening,data extraction,quality evaluation were conducted independently by 2 researchers. Data was analyzed by stata 14.0 software. Results A total of 17 pieces of research involving 766 patients and 7 exercise training were included. The results of network meta-analysis indicated that the dynamic and static balance function,comprehensive balance level and lower limbs muscle strength were improved by interactive video game-based exercise training and traditional balance exercise training+instruments assistant balance exercise training+whole-body vibration training compared with routine treatment (P<0.05). The static balance function was improved using instruments assistant balance function training compared with traditional balance exercise training (P<0.01). Probability ranking indicated that the most effective exercise training was traditional balance exercise training+instruments assistant balance exercise training+whole-body vibration training. Conclusion The study showed that the best exercise training improving balance function of patients with DPN was traditional balance exercise training+instruments assistant balance exercise training+whole-body vibration training. However,more rigorous randomized control trials need to be designed in the future.

Key words: Diabetic Peripheral Neuropathy, Exercise, Balance, Network Meta-Analysis, Rehabilitation Nursing

摘要：

目的 通过网状Meta分析评价7种运动训练对糖尿病周围神经病变患者平衡功能的影响。 方法 检索中国生物医学数据库、中国学术期刊数据库、万方数据库、维普数据库、PubMed、Embase、Scopus、Web of Science及Cochrane Library数据库中关于运动训练对糖尿病周围神经病变患者平衡功能影响的随机对照试验。检索时限为建库至2020年8月。由2名研究者独立进行文献筛选、提取及质量评价。采用Stata 14.0进行网状Meta分析。 结果 纳入17项研究,共766例,运动训练类型共7种。网状Meta分析结果表明,与常规运动相比,采用虚拟情景平衡功能训练、传统联合器械辅助平衡功能训练+全身振动训练可提升患者的动态及静态平衡能力、综合平衡功能及下肢肌肉力量 (P<0.05) ;与传统平衡功能训练相比,采用器械辅助平衡功能训练可提升患者的静态平衡水平 (P<0.01) 。采用传统联合器械辅助平衡功能训练+全身振动训练的疗效最佳。 结论 该研究结果提示,传统联合器械辅助平衡功能训练+全身振动训练是改善糖尿病周围神经病变患者平衡功能的最优训练方式,但仍需要更多的研究进一步论证。

关键词: 糖尿病周围神经病变, 运动, 平衡, 网状Meta分析, 康复护理