D. Lubenova 1, E. Titianova 2, A. Dimitrova 1
1 National Sports Academy Vassil Levski – Sofia,
2 Military Medical Academy – Sofia, Bulgaria
Objective: To assess the effect of a structured physical therapy (PT) programme on the orthostatic reactivity in patients with diabetic neuropathy (DNP).
Material and Methods: The study was performed in 90 patients with DNP (38 male and 52 female, mean age 60.8±7.8 years) of lower extremities. The orthostatic autoregulation was evaluated using an active orthostatic test. The arterial blood pressure and the heart rate were determined after 10 minutes of rest in lying position before and after 1, 5 and 10 minutes of active standing. All patients had therapy with alpha-lipoic acid and a structured intensive 10 days PT program, later continued as a home exercise programme. The orthostatic autoregulation was evaluated three times – at the start of the study, at day 10 and at week 6 after the beginning of PT. The classification of Thulesius was used to divide the patients into 3 groups according to the type of their orthostatic reactivity.
Results: At the start of the study a normotonic orthostatic reactivity (NOR) was observed in 32 patients. Abnormal sympathicotonic type of orthostatic reactivity (SOR) was found in 18 patients and asympaticotonic type of orthostatic reactivity (AOR) was established in the remaining 40 patients.
Discussion: After the PT treatment a significant improvement of the orthostatic autoregulation in the groups with SOR and AOR was found – NOR was observed in 66 patients with DNP (80.3%) at 6 weeks after the start of PT.
Key words: exercise therapy, orthostatic tolerance, physical therapy, type II diabetes.