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IRCT201307142391N13 IRCT 2014-05-08 Vice Chancellor for Research of Shiraz University of Medical Sciences The effect of therapeutic exercise in diabetic patients Comparison of the effect of two type of therapeutic exercise Frenkel vs. Swiss ball on the clinical balance indices in patients with diabetes type 2 associated with neuropathy 2014-04-21 anticipated 60 Complete https://irct.ir/trial/2063 interventional Randomization: N/A, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment. N/A Diabete type2. Intervention 1: intervention group 1,Swiss ball training: balance training in sitting position: 1- holding balance position on ball 2- holding balance position on ball with active movements of one sided upper extremity 3- holding balance position on ball with active movements of two sided upper extremity 4- holding balance position on ball with trunk movements (bending forward and rotation) 5- holding balance position on ball with heel raising 6- holding balance position on ball with toes raising 7- holding balance position on ball with raising heel and toes simultaneous 8- resistance against perturbation 9- weight shifting on ball ball training in standing position: 1- picking up and down the ball with two upper extremity in a straight line 2- picking up and down the ball with two upper extremity in an oblique line 3- moving the ball forward and backward with left and right lower extremity 4- moving the ball in lateral sides with left and right lower extremity 5- throwing ball toward the wall with hand 6- throwing ball toward the wall with foot. Intervention 2: control group: clinical balance indices is measured without intervention. Intervention 3: intervention group 2,Frenkel exercise: in supine position: 1- patient bends one leg at the hip and knee, as heel along the bed,Repeats with the other leg 2- Bends one leg at the hip and knee and Then straights his hip and knee to return to the starting position. Repeats with the other leg 3- Bends one leg with the heel raises from the bed. Repeats with the other leg 4- Bends one leg and place it at the at any point of command. Repeats with the other leg 5- Bends one leg and places that heel on the opposite knee Then slides her heel down the shin to the ankle and back up to his knee and Returns to the starting position.repeats with the other leg 6- Bends both legs and then keeps his ankles together Straighten both legs to return to starting position 7- Bend one leg in a bicycling motion in sitting position: 1- raises the heel Then progress to alternately lifts the entire foot and placing the foot on the floor upon a traced foot print 2- Alternately glides the foot over the marked cross forward, backward and lateral side 3- at first rises from the chair, at second bends trunk forward then rises the trunk and Reverses the procedure to sit down in standing position: 1- shifts the weight to the left foot and places the right foot 12 inches to the right and Repeats exercise with the left side 2- Walks forward between two parallel line 14 inches apart placing 3- Walks forward placing each foot on a footprint traced on the floor( Foot prints is parallel and 2 inches from a center line) 4- Turns to the right and places at the right toe and rotates the right and places right foot on the floor then rotates the right,repeats to the left 5- Walks up and down the stairs and Places the right foot on one step and brings the left up beside it.
public Zahra Rojhani Shirazi
Shiraz Faculty Rehabilitation,Street Abyverdy,Chamran Boulvard
Shiraz Iran (Islamic Republic of) +98 71 1627 1552 rojhaniz@sums.ac.ir Shiraz University Of Medical Science scientific Zahra Rojhani Shirazi
Faculty Of Rehabilitation,Srtreet Abyverdy,Chamran Boulvard
Shiraz Iran (Islamic Republic of) +98 71 1627 1552 rojhaniz@sums.ac.ir Shiraz faculty of rehabilitation Iran (Islamic Republic of) Inclusion criteria: diabetic neuropathy type 2 referred from physician ; between 40-65 years old ; with18-30 body mass index should have the score f more than two in Michigan neuropathy test.Exclusion criteria: lower extremity complications such as fracture and dislocation at least during six months ago ; any history of surgical operations in muscles,bones and joints of lower extremity ; pain in ankle and knee joint during test ; musculo-skeletal disorders such as rheumatoid and myopathy ; middle ear and vestibular impairments in the patient self report ; knee joint flextion contracture ; using supportive equipments in gait ; stop intervention more than two days any way ; cardiovascular problems and hypertension. 40 years 65 years Both E11 Non-insulin-dependent diabetes mellitus Other N/A Other intervention group 1,Swiss ball training: balance training in sitting position: 1- holding balance position on ball 2- holding balance position on ball with active movements of one sided upper extremity 3- holding balance position on ball with active movements of two sided upper extremity 4- holding balance position on ball with trunk movements (bending forward and rotation) 5- holding balance position on ball with heel raising 6- holding balance position on ball with toes raising 7- holding balance position on ball with raising heel and toes simultaneous 8- resistance against perturbation 9- weight shifting on ball ball training in standing position: 1- picking up and down the ball with two upper extremity in a straight line 2- picking up and down the ball with two upper extremity in an oblique line 3- moving the ball forward and backward with left and right lower extremity 4- moving the ball in lateral sides with left and right lower extremity 5- throwing ball toward the wall with hand 6- throwing ball toward the wall with foot control group: clinical balance indices is measured without intervention intervention group 2,Frenkel exercise: in supine position: 1- patient bends one leg at the hip and knee, as heel along the bed,Repeats with the other leg 2- Bends one leg at the hip and knee and Then straights his hip and knee to return to the starting position. Repeats with the other leg 3- Bends one leg with the heel raises from the bed. Repeats with the other leg 4- Bends one leg and place it at the at any point of command. Repeats with the other leg 5- Bends one leg and places that heel on the opposite knee Then slides her heel down the shin to the ankle and back up to his knee and Returns to the starting position.repeats with the other leg 6- Bends both legs and then keeps his ankles together Straighten both legs to return to starting position 7- Bend one leg in a bicycling motion in sitting position: 1- raises the heel Then progress to alternately lifts the entire foot and placing the foot on the floor upon a traced foot print 2- Alternately glides the foot over the marked cross forward, backward and lateral side 3- at first rises from the chair, at second bends trunk forward then rises the trunk and Reverses the procedure to sit down in standing position: 1- shifts the weight to the left foot and places the right foot 12 inches to the right and Repeats exercise with the left side 2- Walks forward between two parallel line 14 inches apart placing 3- Walks forward placing each foot on a footprint traced on the floor( Foot prints is parallel and 2 inches from a center line) 4- Turns to the right and places at the right toe and rotates the right and places right foot on the floor then rotates the right,repeats to the left 5- Walks up and down the stairs and Places the right foot on one step and brings the left up beside it. Balance. Timepoint: Before intervention,one day after intervantion. Method of measurement: Berg Balance Scale Test,Star excursion Test,time of leg stance. Vice Chancellor for Research of Shiraz University of Medical Sciences Approved 2014-04-14 Shiraz University of Medical Science Shiraz faculty Rehabilitatin,Abyverdy Street,Chamrac Boulvard Shiraz Iran (Islamic Republic of)