Exercise for people with peripheral neuropathy

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Abstract-Research from Cochrane Database Syst Rev. 2004 Oct

18;4:CD003904.

Exercise for people with peripheral neuropathy.

White C, Pritchard J, -Stokes L.

Physiotherapy Division, GKT School of Biomedical Sciences, Kings College

London, Shepherds House, Guy's Campus, London Bridge, London, UK, SE1

1UL.

BACKGROUND: Peripheral neuropathies are a wide range of diseases

affecting the peripheral nerves. Demyelination or axonal degeneration

gives rise to a variety of symptoms including reduced or altered

sensation, pain, muscle weakness and fatigue. Secondary disability

arises and this may result in adjustments to psychological and social

function. Exercise therapy, with a view to developing strength and

stamina, forms part of the treatment for people with peripheral

neuropathy, particularly in the later stages of recovery from acute

neuropathy and in chronic neuropathies.

OBJECTIVES: The primary objective was to examine the effect of exercise

therapy on functional ability in the treatment of people with peripheral

neuropathy. In addition, secondary outcomes of muscle strength,

endurance, broader measures of health and well being, as well as

unfavourable outcomes were examined.

SEARCH STRATEGY: We searched the Cochrane Neuromuscular Disease Group

register (July 2002 and updated February 2004) and MEDLINE (from January

1966 to June 2004), EMBASE (from January 1980 to June 2004), CINAHL

(from January 1982 to July 2002) and LILACS (from January 1982 to July

2002) electronic databases. Bibliographies of all selected randomised

controlled trials were checked and authors contacted to identify

additional published or unpublished data.

SELECTION CRITERIA: Any randomised or quasi-randomised controlled trial

comparing the effect of exercise therapy with no exercise therapy or

drugs or an alternative non-drug treatment on functional ability (or

disability) in people with peripheral neuropathy at least eight weeks

after randomisation was included.

DATA COLLECTION AND ANALYSIS: Two reviewers independently selected

eligible studies, rated the methodological quality and extracted data.

MAIN RESULTS: Only one trial fully met the inclusion criteria. An

additional two trials assessed outcomes less than eight weeks after

randomisation and were also included. Methodological quality was poor

for several criteria in each study. Data used in the three studies could

not be pooled due to heterogeneity of diagnostic groups and outcome

measures. The results of the included trials failed to show any effect

of strengthening and endurance exercise programmes on functional ability

in people with peripheral neuropathy. However, there is some evidence

that strengthening exercise programmes were moderately effective in

increasing the strength of tested muscles.

REVIEWERS' CONCLUSIONS: There is inadequate evidence to evaluate the

effect of exercise on functional ability in people with peripheral

neuropathy. The results suggest that progressive resisted exercise may

improve muscle strength in affected muscles.

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Exercise for people with peripheral neuropathy

White CM, Pritchard J, -Stokes L

http://www.cochrane.org/reviews/en/ab003904.html

Abstract

Background

Peripheral neuropathies are a wide range of diseases affecting the

peripheral nerves. Demyelination or axonal degeneration gives rise

to a variety of symptoms including reduced or altered sensation,

pain, muscle weakness and fatigue. Secondary disability arises and

this may result in adjustments to psychological and social function.

Exercise therapy, with a view to developing strength and stamina,

forms part of the treatment for people with peripheral neuropathy,

particularly in the later stages of recovery from acute neuropathy

and in chronic neuropathies.

Objectives

The primary objective was to examine the effect of exercise therapy

on functional ability in the treatment of people with peripheral

neuropathy. In addition, secondary outcomes of muscle strength,

endurance, broader measures of health and well being, as well as

unfavourable outcomes were examined.

Search strategy

We searched the Cochrane Neuromuscular Disease Group register (July

2002 and updated September 2005) and MEDLINE (from January 1966 to

August 2005), EMBASE (from January 1980 to August 2005), CINAHL

(from January 1982 to August 2005) and LILACS (from January 1982 to

July 2002) electronic databases. Bibliographies of all selected

randomised controlled trials were checked and authors contacted to

identify additional published or unpublished data.

Selection criteria

Any randomised or quasi-randomised controlled trial comparing the

effect of exercise therapy with no exercise therapy or drugs or an

alternative non-drug treatment on functional ability (or disability)

in people with peripheral neuropathy at least eight weeks after

randomisation was included.

Data collection and analysis

Two authors independently selected eligible studies, rated the

methodological quality and extracted data.

Main results

Only one trial fully met the inclusion criteria. An additional two

trials assessed outcomes less than eight weeks after randomisation

and were also included. Methodological quality was poor for several

criteria in each study. Data used in the three studies could not be

pooled due to heterogeneity of diagnostic groups and outcome

measures. The results of the included trials failed to show any

effect of strengthening and endurance exercise programmes on

functional ability in people with peripheral neuropathy. However,

there is some evidence that strengthening exercise programmes were

moderately effective in increasing the strength of tested muscles.

Authors' conclusions

There is inadequate evidence to evaluate the effect of exercise on

functional ability in people with peripheral neuropathy. The results

suggest that progressive resisted exercise may improve muscle

strength in affected muscles.

White CM, Pritchard J, -Stokes L. Exercise for people with

peripheral neuropathy. Art. No.: CD003904. DOI:

10.1002/14651858.CD003904.pub2

Date of last subtantive update: July 14. 2004