Safety of lower extremity neurodynamic exercises in adults with diabetes mellitus: a feasibility study.
Benjamin S Boyd, Robert J Nee, Betty Smoot
PMID 28855790WHAT IT FOUND
A single session of five lower-limb neurodynamic exercises was tolerated by adults with diabetes.
No neuropathic symptoms were provoked, one calf cramp resolved quickly, and treated-leg straight-leg-raise mobility increased by 5.2° and 5.3°.
Key findings
01No participant reported reproduction or exacerbation of neuropathy symptoms.
02The only discomfort reported was a calf cramp that resolved within 30 seconds.
03The treated right leg showed immediate 5.2° and 5.3° increases in straight-leg-raise mobility.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only 20 adults recruited by advertisement, so it is a small feasibility sample. It tested one session only, so it does not show what repeated neurodynamic exercises do over time. The five exercises were performed together, so the contribution of any single exercise cannot be separated. The average treated-leg mobility increase was about 5°, and 15-30% of participants did not exceed the 2° measurement-error threshold. Participants had diabetes with no neuropathy or mild-to-moderate neuropathy and no foot ulcers, so severe neuropathy, ulcerations, and children are not addressed. The examiner and participants were not blinded, and medications were not controlled. The study did not test whether the mobility changes improved function.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that neurodynamic exercises improve function or are effective for diabetes. The study measured only immediate straight-leg-raise mobility after one session in 20 adults, did not measure function, and could not separate the effects of the five exercises.