Effects of resistive exercise or proprioceptive exercise training on balance and superficial sense of patients with type 2 diabetes mellitus

The aim of the study is to investigate proprioceptive exercises training combined with aerobic exercises and resistive exercises training combined with aerobic exercises on dynamic balance and superficial sense. The study included 30 volunteers with Type 2 Diabetes Mellitus(T2DM) (24F, 6M; 51.23±7.68 years) who were referred to Fitness Center Arif Nihat Asya Kültür Merkezi Istanbul, Turkey by a medical doctor between December 2016- March 2017 and got diagnosed and followed up at least 6 month before. Glycemic control of all the participants were assessed according to fasting blood glucose and glycolated hemoglobin (HbA1c). Waist and hip circumference was recorded in centimeters. Six minute walking test (6MWT) was used to determine functional capacity of participants. We evaluated the dynamic balance of patients by Prokin PK200, Italy. Five parameters were obtained from Prokin as; Perimeter Length (PL), Area gap percentade (AGP) Medium Speed (MS), Anteroposterior equilibrium (AP) and Mediolateral equilibrium (ML). Proprioception assessment was done with angle reproduction test in direction of dorsiflexion and plantar flexion and deviations were recorded. Superficial sense was assessed with two point discrimination test and vibration threshold was evaluated by biothesiometer. Lower extremity muscles strength were assessed with handheld dynamometer (PowerTrack II commander, JTech Medical, Midvale, UT). The patients were randomly divided into Proprioceptive Exercise Training Group (PG) (n=15) and Resistive Exercise Training Group (RG) (n=15). All subjects were included exercise education program and both groups had trained aerobic exercise program for walking on treadmill (2times/wk. 6 week duration). The proprioceptive exercise program was applied in PG and the resistive exercise program was applied in RG twice a week and for duration 6 week. The main results of this study comparing two groups, PG showed greater improvement in vibration perception threshold values from the first and third metatarsal head of right foot and fifth metatarsal head of left foot.(respectively p=0.04, p=0.005, p=0.001). Consistent with hypothesis, we found that proprioceptive exercises combined with aerobic exercise program was more effective to improve vibration sense and dynamic balance findings of people with T2DM compared to a program including resistive exercise combined with aerobic exercises Key Words: aerobic exercise, dynamic balance, fasting blood glucose, functional capacity, HbA1c, muscle strength, proprioceptive exercises training, resistive exercise training, sensation, Type 2 Diabetes Mellitus, vibration threshold, waist and hip circumference.