SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Neurorehabilitation
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1610955
Effectiveness of exercise on musculoskeletal function and clinical outcomes in patients with diabetic peripheral neuropathy: A systematic review and meta-analysis
Provisionally accepted
- 1Chengdu Medical College, Chengdu, China
- 2Sichuan Mianyang 404 Hospital, Mianyang, China
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Background: Diabetes mellitus is a major public health issue, and its complication, diabetic peripheral neuropathy (DPN), can significantly impair foot and ankle joint function, affecting daily activities and quality of life. This systematic review and meta-analysis aimed to evaluate the impact of exercise on musculoskeletal function and clinical outcomes in DPN patients. Methods: Evaluation of randomized controlled trials (RCTs) of exercise in patients with DPN published from Cochrane Library, PubMed, Embase, Web of Science, Medline, ClinicalKey, CNKI, Wanfang database, VIP Chinese Journal Database, and Chinese Biomedical Literature Database was performed. Revman 5.4 software was used for statistical analysis. Results: A total of 625 samples were included in 10 studies. It showed that exercise significantly increased ankle dorsiflexion range of motion (SMD = 0.61, 95%CI (0.13, 1.08), P<0.05), ankle flexion range of motion (SMD=0.59, 95% CI (0.12, 1.06), P<0.05), hallux strength (MD=1.89, 95%CI (1.00, 2.78), P<0.001), toes strength (MD=2.51, 95%CI (1.69, 3.33), P<0.001) and lower extremity functional strength (MD=-2.82, 95%CI (-3.88, -1.76), P<0.001), whereas reduced glycosylated hemoglobin (SMD=-1.44, 95%CI (-2.30, -0.57), P<0.01) and body mass index (MD=-0.86, 95%CI (-1.15, -0.57), P<0.001). However, discrepancies were observed between pooled results based on different neuropathy assessment tools.The available evidence suggests that exercise training is an effective method for improving peripheral neuropathy. Systematic review registration: https://inplasy.com/, identifier INPLASY202340 112.
Keywords: Diabetic peripheral neuropathy, clinical outcomes, Musculoskeletal function, Exercise, Meta-analysis
Received: 14 Apr 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Yang, Li, Ye, Pu, Yao, Luo, Huang, Zhang and YANG. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xianqin Zhang, Chengdu Medical College, Chengdu, China
ZHENG YANG, Chengdu Medical College, Chengdu, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.