title: Safety of aerobic exercise in people with diabetic peripheral neuropathy: single-group clinical trial.
abstract: BACKGROUND
  Exercise is recommended for people with diabetes, but little is known about exercise in people with diabetic peripheral neuropathy (DPN).
  
  
  OBJECTIVE
  The primary purpose of this preliminary study was to examine adverse events (AEs) during moderate-intensity, supervised aerobic exercise in people with DPN. The secondary purpose was to examine changes in fatigue, aerobic fitness, and other outcomes after intervention.
  
  
  METHODS
  This was a single-group preliminary study.
  
  
  METHODS
  The setting was an academic medical center.
  
  
  METHODS
  Participants were 18 people who were sedentary and had type 2 diabetes and peripheral neuropathy (mean age=58.1 years, SD=5).
  
  
  METHODS
  The intervention was a supervised 16-week aerobic exercise program (3 times per week at 50% to >70% oxygen uptake reserve).
  
  
  METHODS
  Adverse events were categorized as related or unrelated to the study, anticipated or unanticipated, and serious or not serious. Outcomes included fatigue (Multidimensional Fatigue Inventory), cardiovascular fitness (peak oxygen uptake), body composition (dual-energy x-ray absorptiometry), sleep quality, plasma metabolic markers, and peripheral vascular function.
  
  
  RESULTS
  During the study, 57 nonserious AEs occurred. Improvements were found in general fatigue (mean change=-3.5; 95% confidence interval [95% CI]=-1.3, -5.3), physical fatigue (mean change=-3.1; 95% CI=-1.2, -5.0), peak oxygen uptake (mean change=1.1 mL·kg(-1)·min(-1); 95% CI=0.2, 1.9), total body fat (mean change=-1%; 95% CI=-0.3, -1.7), fat mass (mean change=-1,780 g; 95% CI=-616.2, -2,938.7), and peripheral blood flow (mean change=2.27%; 95% CI=0.6, 4.0).
  
  
  CONCLUSIONS
  This was a small-scale, uncontrolled study. A future randomized controlled trial is needed to fully assess the effects of exercise on the outcomes.
  
  
  CONCLUSIONS
  This study provides new support for supervised aerobic exercise in people with DPN. However, it is important for physical therapists to carefully prescribe initial exercise intensity and provide close monitoring and education to address the anticipated AEs as people who are sedentary and have DPN begin an exercise program.
authors.affiliation: P.M. Kluding, PT, PhD, Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160 (USA). pkluding@kumc.edu.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Kluding
authors.affiliation: M. Pasnoor, MD, Department of Neurology, University of Kansas Medical Center.
authors.forename: Mamatha
authors.initials: M
authors.lastname: Pasnoor
authors.affiliation: R. Singh, PhD, Physical Therapy, The Sage Colleges, Troy, New York.
authors.forename: Rupali
authors.initials: R
authors.lastname: Singh
authors.affiliation: L.J. D'Silva, PT, Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: D'Silva
authors.affiliation: M. Yoo, MS, Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center.
authors.forename: Min
authors.initials: M
authors.lastname: Yoo
authors.affiliation: S.A. Billinger, PT, PhD, Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Billinger
authors.affiliation: J.W. LeMaster, MD, MPH, Department of Family Medicine, University of Kansas Medical Center.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: LeMaster
authors.affiliation: M.M. Dimachkie, MD, FANA, Department of Neurology, University of Kansas Medical Center.
authors.forename: Mazen M
authors.initials: MM
authors.lastname: Dimachkie
authors.affiliation: L. Herbelin, BSc, PTA, Department of Neurology, University of Kansas Medical Center.
authors.forename: Laura
authors.initials: L
authors.lastname: Herbelin
authors.affiliation: D.E. Wright, PhD, Department of Anatomy and Cell Biology, University of Kansas Medical Center.
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Wright
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D001916:Brachial Artery / Q000502:physiology; D003929:Diabetic Neuropathies / Q000503:physiopathology / Q000534:rehabilitation*; D015444:Exercise; D005221:Fatigue / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D012042:Registries; D057185:Sedentary Behavior; D012890:Sleep / Q000502:physiology; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers