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Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes -- preliminary randomised controlled trial [with consumer summary]
Cox ER, Gajanand T, Burton NW, Coombes JS, Coombes BK
Diabetes Research and Clinical Practice 2020 Apr;164:108168
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

AIMS: People with type 2 diabetes (T2D) have a greater prevalence of musculoskeletal and neuropathic pain. This exploratory analysis investigated whether exercise of different intensities leads to changes in self-reported musculoskeletal pain or symptoms of diabetic neuropathy in inactive individuals with type 2 diabetes. METHODS: Thirty-two inactive adults with T2D (59% male, mean age 58.7 +/- 9.1 yrs, median HbA1c 7.8%) were randomised to usual care (CON), supervised combined aerobic and resistance moderate-intensity continuous training (C-MICT), or supervised combined high-intensity interval training (C-HIIT). At baseline and 8-weeks, musculoskeletal and neuropathic pain were evaluated using a modified Nordic Musculoskeletal Questionnaire and the Neuropathy Total Symptom Score-6 respectively. Quantitative sensory testing was used to determine thermal, mechanical and vibration detection thresholds, as well as pain pressure thresholds. Adverse events were recorded throughout the intervention. RESULTS: Compared to CON, reduction in musculoskeletal pain intensity was significantly greater for C-HIIT (MD -5.4, 95% CI -10.6 to -0.2, p = 0.04) and non-significantly greater for C-MICT (MD -5.9, -12.4 to 0.7, p = 0.08). Changes in neuropathy symptoms were not different between C-HIIT and CON (MD 1.0, -0.9 to 2.8, p = 0.31), or C-MICT and CON (MD 0.2, -3.1 to 3.6, p = 0.89). No differences in sensory function were observed between groups. Similar rates of adverse events were seen in both exercise interventions (19 C-HIIT; 17 C-MICT), all but one of which were mild. CONCLUSIONS: Preliminary data suggests 8-weeks of high-intensity combined aerobic and resistance exercise may be safely prescribed for inactive individuals with T2D and may reduce musculoskeletal pain but not neuropathic symptoms. TRIAL REGISTRATION: ACTRN12615000475549.
With permission from Excerpta Medica Inc.

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