Kinesiotherapy in painful diabetic polyneuropathy

Abstract

   Objective: to evaluate the effect of kinesiotherapy on the intensity of neuropathic pain, physical activity and emotional state of patients with diabetic polyneuropathy (DPN).   Material and methods. The study included 65 patients with a painful form of DPN who were randomly divided into two groups: the standard therapy (ST) group and the extended therapy (ET) group, in which three to four additional face-to-face sessions were conducted to create a 15-minute individualized exercise program. The type of neuropathic pain was assessed using the Neuropathy Total Symptom Score – 9 (NTSS-9). Pain intensity was assessed using a visual analogue scale (VAS), patients' emotional state was assessed using the Beck Depression Scale and the Spielberger Anxiety Scale (with an assessment of personal anxiety). The examination was carried out at baseline, and after 3 and 6 months. At baseline, patients in the ST and ET groups did not differ (p ≥ 0.05) in parameters such as pain intensity according to VAS (6.65 ± 1.93 and 6.07 ± 1.91 points respectively), neuropathic pain according to NTSS-9 (13.65 ± 4.54 and 11.79 ± 5.09 points respectively), physical activity according to IPAQ-SF (20.1 ± 10.0 and 18.8 ± 9.1 points), personal anxiety according to Spielberger scale (51.00 ± 6.10 and 47.33 ± 9.73 points), depression according to Beck scale (15.75 ± 7.77 and 14.67 ± 8.73 points).   Results. After treatment, there was a more significant reduction in pain intensity according to VAS in the ET group than in the ST group – to 3.67 ± 2.55 and 6.10 ± 1.41 points respectively after 3 months (p < 0.05) and to 2.60 ± 1.45 and 5.80 ± 1.06 points respectively after 6 months (p < 0.001), reduction in neuropathic pain according to NTSS-9 scale to 4.88 ± 4.39 and 13.13 ± 2.96 points after 3 months (p < 0.001) and to 3.55 ± 2.52 and 13.08 ± 3.86 points after 6 months (p < 0.001), a decrease on the personal Spielberger Anxiety Scale to 42.33 ± 7.66 and 51.30 ± 7.22 points after 6 months (p = 0.01), a decrease on the Beck Depression Scale to 10.07 ± 9.31 and 16.70 ± 4.34 after 6 months (p < 0.05).   Conclusion. Kinesiotherapy in complex therapy of DPN leads to a reduction in pain and an improvement in functional and emotional state of patients.