Efficacy of upper limb training on grip strength and muscle activity in individuals with type 2 diabetes: a feasibility study

Abstract

Abstract The upper limb (UL) is one of the important target for musculoskeletal complications in patients with diabetes. The objective of this trial was to measure the feasibility and clinical effectiveness of upper limb training on grip strength and muscle activity in individuals with Type 2 Diabetes mellitus (T2DM). A parallel three-arm randomised controlled trial (RCT) was employed. Fifty-seven patients with T2DM aged between 35 to 60 years were recruited based on eligibility criteria and asked to visit the outpatient department (OPD) of physiotherapy. They were randomly allocated into 3 groups; resistance training (RT) group; sensorimotor training (SMT) group; and control group with the help of a computer-generated random number table. Primary outcome measures were recruitment rate, outcome measure, retention rate, adherence, and acceptability of the intervention to assess trial feasibility. The efficacy of training on grip strength and on activation of deltoid, bicep and triceps brachii after 6 weeks was measured using a JAMAR hand dynamometer and S4-channel Neurostim EMG/NCV/EP system, respectively. The feasibility of recruitment rate of participants was 72.15%, outcome measures feasibility was 81%, retention rate of participants was 81% and intervention adherence was 91.34% for RT group & 87.41% for SMT group. Most of the participants were satisfied with the given intervention as the acceptance rate was high. Between and within-group analysis of muscular activity and strength shows a significant difference as the P-value was < 0.05. RT group shows maximum improvement in both outcome measures. This study was feasible and well accepted by participants. Therefore, it is possible to perform a fully powered RCT and to use upper limb training in the future for good clinical management in type 2 diabetic population. This trial was registered under the Clinical Trial Registry of India (CTRI) with registration no. CTRI/2021/06/034188.