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Exercise for people with peripheral neuropathy

Exercise for people with peripheral neuropathy. Karin Faber CAT, 8 september 2005. P: peripheral neuropathy I: exercise therapy C: no-exercise therapy or drugs O: functional ability at least 8 weeks after start of intervention. Cochrane review 2004

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Exercise for people with peripheral neuropathy

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  1. Exercise for people with peripheral neuropathy Karin Faber CAT, 8 september 2005

  2. P: peripheral neuropathy I: exercise therapy C: no-exercise therapy or drugs O: functional ability at least 8 weeks after start of intervention

  3. Cochrane review 2004 481 hits, waarvan 29 artikelen 28 studies beschreven Hiervan 3 RCT’s 1 trial voldeed aan alle inclusie criteria 2 trials voldeden niet aan de uitkomstmaten, maar werden wel geincludeerd

  4. Inclusie • Lindeman 1995. • Richardson 2001 • Ruhland 1997 • Totaal 82 patienten (37 HMSN, 25inflammatory (CIDP),20 metabolic aetiology)

  5. Methodologie Blinding moeilijk bias? Randomisatie: 1 onduidelijk, 2 inadequaat Diagnostische criteria: expliciet in 1 Duidelijke omschrijving van outcome criteria: 3, maar slechts 1 studie met gevalideerde meting na 8 weken

  6. Resultaten- primaire uitkomstmaat Verschil in benodigde tijd om 6 meter te lopen vóór en na 24 weken training

  7. Resultaten- primaire uitkomstmaat • Ruhland, 1997: geen verschil in functional ability (SF-36)

  8. Resultaten- secundaire uitkomstmaat Geen verschil in maximale isometrische contractie kracht of in uithoudingsvermogen bij 80% MVC (sec)

  9. Resultaten- secundaire uitkomstmaat • Ruhland 1997 : klein verschil in average muscle scores • Geen verschil in knijpkracht li of re

  10. Interpretatie • Pooling niet mogelijk ivm verschillende outcome measures en interventies • Slechts 1 trial voldeed aan de inclusie criteria (34 pat) • Geen goede blindering mogelijk • Outcome measures ≠ algemeen functioneren of sociale participatie

  11. Conclusie • Weinig bewijs dat oefenen effect heeft • Enig bewijs dat er matige toename is van spierkracht in de onderzochte spieren • Studies methodologisch zwak • Geen nadelige effecten

  12. Literatuur • White CM, et al. Exercise for people with peripheral neuropathy. Cochrane Database of Syst Rev 2004, issue 4 • Lindeman E, et al. Strength training in patients with myotonic dystrophy and hereditary motor and sensory neuropathy: a randomised clinical trial. Arch Phys Med Rehab 1995;76:612-620 • Richardson J. et al. A focussed exercise regome improves clinical measures of balance in patients with peripheral neuropathy. Arch Phys Med Rehab 2001;82:205-209 • Ruhland J et al. The effects of a home exercise programme on impairment and health related quality of life in persons with chronic peripheral neuropathies. Phys Ther 1997;77:1026-1039

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