Role of Physiotherapy in managing type 2 diabetes mellitus: A systematic review

Abstract

Type 2 diabetes mellitus (T2DM) is the most widespread form of diabetes and is becoming a global burden. This disorder distresses almost all of body systems leading to a number of complications such as cardiovascular diseases, diabetic peripheral neuropathy, diabetic nephropathy, musculoskeletal disorders and lower limb amputations which in turn increase the rate of mortality and impoverished life’s quality. This beseeches for better treatment methods, but the pharmacological approaches are limited by their adverse effects. In that context physiotherapy is an emerging non-pharmacological approach. The objective of this review was to systematically review the current evidence on role of physiotherapy in type 2 diabetes patients. A comprehensive search of literature published between 2010 to 2021 was conducted using; PubMed, ScienceDirect and PEDro databeses. 34 RCTs determining the role of different physiotherapy interventions published in peer reviewed English language journal were included in this review. Studies with less than 20 participants and conducted in age less than 18 years were excluded. This review was conducted in compliance with PRISMA guidelines. Study quality was assessed using PEDro scale; data on participant and intervention characteristics, outcome measures and treatment outcomes were extracted based on PICO framework by one reviewer under the supervision of another reviewer. The quality of trials as per PEDro was a mean score of 6. Overall, these studies evaluated the role of physiotherapy interventions such as exercise therapy, electrotherapy and other new and uncommon interventions such as pilates, whole body vibration and mini-trampoline in improving T2DM patients. This was the first systematic review to gather the evidence related to role of physiotherapy as a non-pharmacological approach in managing T2DM. The findings of present review suggested that different physiotherapeutic interventions have a positive role to play in management of T2DM and its associated complications but the literature is mainly focused on exercise therapy although many other physiotherapy interventions also proved to be beneficial.