Exercise and Peripheral Neuropathy
Longevity Exercise Physiology Drummoyne, Edgecliff, Marrickville, Bella Vista, Randwick, Pymble, Balmain and Neutral Bay examine the role of exercise in managing Peripheral Neuropathy.
What is Peripheral Neuropathy (PN)?
Peripheral neuropathy is a term for the conditions that involve damage to nerves, especially those in our limb extremities. When this damage occurs, it impacts/prevents the messages travelling from our brain and spinal cord to the skin, muscles and other parts of the body.
Peripheral Neuropathy is commonly associated numbness, muscle weakness, pain, cramps. The symptoms someone may experiences depends on the type & location of damaged nerve fibres (NINDS, 2021).
“One third of people aged 65 years and over are estimated to have symptoms attributed to Peripheral Neuropathy”
| Type of Nerve Affected | Nerve Function | Common symptoms |
| Motor Nerve | Associated with movement | Muscle weakness, Cramps, |
| Sensory | Allows for sensory information to be sent to the brain i.e temperature, texture or if a body part is still in motion. | Tingling, numbness, pain or sensitivity to touch |
| Autonomic | Controls the involuntary/semi-voluntary functions of the body i.e sweating, heart rate, blood pressure. | Dizziness when standing up, excessive sweat, insufficient sweat |
Why does PN occur?
Neuropathy can be caused by many factors and health conditions; physical injuries/trauma, blood and blood vessel issues that decrease oxygen flow, systemic diseases, kidney and liver disorders and more. Anything that damages nerves can result in PN.
However one of the main causes associated with PN is diabetes – it is found to be about 60-70% of people with diabetes have some form of PN (Dixit, 2014).
Where do symptoms usually occur and how can it affect people?
The most common symptoms are usually numbness, weakness and pain (burning and tingling) in hands and feet i.e. pain when there isn’t usually, abnormal grip strength.
These symptoms can result in difficulty to perform usual daily activities, reduced exercise and increased stress (Abkari et.al, 2012).
Can Peripheral Neuropathy be reversed?
Research shows it’s highly unlikely that the nerve damage can be reversed, however, symptoms and their effects on a person’s livelihood can be managed and improved.
(John Hopkins Medicine, 2021)
How can exercise help?
Exercise has been shown to be beneficial and safe for those with PN. Exercising with
Peripheral Neuropathy has been shown to:
- Improve balance
- Improve walking ability, technique and speed
- Maintain independence and ability to complete everyday tasks
- Reduced muscle loss
“Although peripheral neuropathy is unlikely to be reversed, exercise can help improve and maintain independence and function”
What kind of exercises are recommended for Peripheral Neuropathy?
Balance, aerobic, flexibility and strength training have all been shown to have positive effects on peripheral neuropathy and its symptoms. Due to reduced sensation and feeling in the peripherals (especially feet) balance can become a problem. So, it is particularly important to strengthen other aspects of balance to help compensate for this!
The aim is to meet the recommended exercise guidelines of 150 mins of aerobic exercise and 2-3 resistance training sessions in a week. However, an individual’s tolerance to exercise should be considered – start off with what is tolerable and build towards the guidelines (Streckmann et.Al, 2014).
Balance training
Balance training is important for peripheral neuropathy specifically for falls prevention and increased ability to stay balanced during everyday activities.
Examples are:
- Tandem Walking
- Single leg balance
- Bosu ball squat
- Sit to stands
Aerobic exercise
Aerobic exercise is effective for improving heart health, independence, preventing weight gain, fatigue and reducing progression of PN symptoms. It achieves this through improving peripheral blood flow and increased mobility and energy usage.
Aiming to meet the physical activity guidelines of 150 minutes moderate intensity aerobic activity in a week is the goal for those with peripheral neuropathy.
- Walking at a 5/10 difficulty rating
- Using a stationary exercise bike
- Recumbent bike
- Rowing Ergometer.
Resistance training
Resistance training is specifically useful in increasing muscle strength that allows for greater activity endurance and assists in balance ability. Resistance training is particularly good for those with Diabetic PN as it decreases insulin sensitivity, reduced fatty body mass and encourages better glucose control.
- Body weight exercises e.g Sit to stand, Push-ups
- Weight machines e.g Leg press, Chest press
- Free-weight Training e.g Barbell bench press, deadlift
Flexibility / Stretching
Flexibility and stretch training has been shown to increase blood flow and range of movement in muscles and joints. Incorporating stretching into your daily routine before periods of activity or exercise can help improve symptoms and performance. Dynamic stretching is very useful but balance and falls risk need to be considered.
- Quadriceps stretch
- Knee rocks – lower back movement
- Calf stretch
- Hamstring sweep throughs or seated hamstring stretch.
If you or someone you know of could benefit from a supervised exercise program for management of Peripheral Neuropathy call Longevity Exercise Physiology Edgecliff, Pymble, Marrickville, Randwick, Drummoyne, Balmain, Bella Vista and Neutral Bay on 1300 964 002 to enquire today!
Written by Grayson Keiran
References:
Akbari, M., Jafari, H., Moshashaee, A., & Forugh, B. (2012). Do diabetic neuropathy patients benefit from balance training?. The Journal Of Rehabilitation Research And Development, 49(2), 333. doi: 10.1682/jrrd.2010.10.0197
Dixit, S., Maiya, A., & Shastry, B. (2014). Effect of aerobic exercise on peripheral nerve functions of population with diabetic peripheral neuropathy in type 2 diabetes: A single blind, parallel group randomized controlled trial. Journal Of Diabetes And Its Complications, 28(3), 332-339. doi: 10.1016/j.jdiacomp.2013.12.006
John Hopkins Medicine. (2021). Peripheral Neuropathy. Retrieved 28 February 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/peripheral-neuropathy#symptoms
NINDS. (2022). Peripheral Neuropathy Fact Sheet | National Institute of Neurological Disorders and Stroke. Retrieved 28 February 2022, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet
Streckmann, F., Zopf, E., Lehmann, H., May, K., Rizza, J., & Zimmer, P. et al. (2014). Exercise Intervention Studies in Patients with Peripheral Neuropathy: A Systematic Review. Sports Medicine, 44(9), 1289-1304. doi: 10.1007/s40279-014-0207-5