Video-based exercise training on pain, physical fitness and sleep in patients with Type II diabetic peripheral neuropathy

This study was conducted to investigate the effects of Video-Based Exercise training on pain, physical fitness and sleep in patients with Type II Diabetic Peripheral Neuropathy. In the study, 56 individuals were randomly divided into 3 groups as Video Based Exercise Training (VTE) group (n=19), Aerobic Exercise (AE) group (n=19) and Control Group (n=18). Table Tennis, Track&Field and 2000 Leaks games were played to the VTE group, simulating individual movements simultaneously with the XBOX 360 Kinect device. The AE group was run on the treadmill. No intervention was made in the Control Group. Training groups were trained for a total of 36 sessions for 12 weeks, 3 times a week. The Control Group was not intervened for 12 weeks and the volunteers from this group were given one of the two trainings after the final evaluation. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), the Neuropathic Pain Questionnaire, and the McGill Pain Scale-short form were used for pain assessment. For physical fitness parameters, Jamar hand dynamometer was used to assess upper extremity muscle strength; manual digital dynamometer was used to view lower extremity muscle strength; the sit and reach test was used to evaluate flexibility; the waist-hip ratio and BMI were used to assess the body composition; the Berg balance scale and Y balance test were used to mark the balance; the 6-minute walk test was used to evaluate functional Physical fitness. Pittsburgh Sleep Quality index (PSQI) and Epworth Sleepiness scale were used for sleep assessment. In addition, all individuals were tested in the concept of the World Health Organization Quality of Life Scale (WHOQOL-Brief), International Physical Activity Questionnaire (IPAQ), Falls Efficacy Scale-International (FES-I), Physical Activity Enjoyment Scale (PACES). Moreover, the foot and knee joint position sense test for proprioception; plantar sense test for sensation (monofilament) and Vibration (diapason) test were used. As a result of the study, in VTE and AE groups improvements were observed in Neuropathic Pain Questionnaire, McGill Pain Scale-short form, LANSS pain scale, 6 min. Walking Test, Lower extremity muscle strength, Y balance test, Berg Balance scale, Foot Joint Position Sense, Knee Joint Position Sense, Monofilament Sense (p<0.05). Right upper extremity muscle strength, International Physical Activity Questionnaire (IPAQ) (MET) value and Vibration sense 256 (Hz) measurements were improved only in VTE group (p<0.05). There was an increase in waist-hip ratio, and an increase in lower extremity muscle strength only in left hip extension just in the Control Group (P<0.05). In the World Health Organization Quality of Life Scale (WHOQOL-Bref) data, a decrease in psychological health, an increase in social relations in the VTE group; an increase in general health in the AE group, and a decrease in the social relations score in the control group were observed (p<0.05). The improvement of the groups in BMI, Sit and reach test, Pittsburgh Sleep Quality index (PSQI), Epworth Sleepiness scale, International Physical Activity Questionnaire (IPAQ) (sitting time), Falls Efficacy Scale-International (FES-I) and Physical Activity Enjoyment Scale (PACES) were similar (P>0.05). In conclusion, significant improvements have been seen in VTE training on Pain, Physical fitness, Physical activity, Proprioception and Sensation. Our 1st and 3rd hypotheses have been confirmed and we recommend the use of VTE training in treatments. Key Words: Type 2 Diabetic neuropathy, Video-based exercise, Pain, Physical fitness, Sleep