Strength Training: Friend or Foe to Diabetes Mellitus?
You may find this hard to believe, but until recently, the ADA and the ACSM guidelines had recommended that people with Diabetes Mellitus (DM) and Peripheral Neuropathy (PN) refrain from weight-bearing activity. Just to be clear, this means they were recommending that people with DM+PN should do exactly what was contributing to their condition.
The rationale was that the risk of skin breakdown was greater than the rewards associated with getting off their butts and moving around a little. Skin breakdown and ulceration can lead to gangrene, amputation and potentially death. These are extreme risks, but they are easily monitored and controlled, enabling a person with DM+PN to live a normal life.
A case study published in Physical Therapy (Jan 2012) details the benefits of weight-bearing activity. The study utilized a moderate intensity 12-week, progressive walking and resistance program reflecting the recently changed guidelines for people with DM+PN. Three times a week for 12-weeks, the 76-year old man (with a 30-year history of DM+PN) performed the following exercises:
- Stretching - toes, hamstrings, quadriceps, calves
- Balance - progressively challenging exercises with decreased support
- Strengthening - body-weight ankle strengthening exercises, stair climbing, sit-to-stand
- Aerobics - progressive treadmill walking
Precautions were taken to avoid skin injury and all exercise sessions were monitored by a physical therapist. Overall the program was successful in increasing some measures of muscle strength, physical function, and activity without causing injury in an individual with DM+PN.
This is very encouraging for patients with DM+PN. PTs should be encouraging this population to be more active and we can even design programs based on the protocol outlined in this study. I know we will be doing exactly that here at
WSPT.
If you have Diabetes Mellitus and are interested in a program to safely increase your activity level, strength, balance and overall conditioning reach out to WSPT @
info@wspt.org.