Rehabilitation interventions for upper limb dysfunction in type 2 diabetes mellitus, with or without diabetic peripheral neuropathy: a systematic review and meta-analysis.
Noor Aziella Mohd Nayan, Mohammed Alrashdi, Hakim Zulkarnaen et al.
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In 30 seconds
This systematic review and meta-analysis assessed upper limb rehabilitation in adults with type 2 diabetes, with or without diabetic peripheral neuropathy (DPN), including randomized and quasi-experimental studies. Eighteen studies (n = 835) were included, four involving people with DPN. Pooled effects were not statistically significant for hand grip strength (MD = 1.58 kg; 95% CI: -0.06 to 3.22), pinch strength (MD = 0.36 kg; 95% CI: -6.80 to 7.52), or dexterity (SMD = -0.43; 95% CI: -1.61 to 0.75). Narrative synthesis suggested potential benefits from multicomponent programs.
Key findings
- Pooled hand grip strength effect was MD = 1.58 kg; 95% CI: -0.06 to 3.22, not statistically significant.
- Pooled pinch strength effect was MD = 0.36 kg; 95% CI: -6.80 to 7.52, not statistically significant.
- Dexterity effect was SMD = -0.43; 95% CI: -1.61 to 0.75, not statistically significant.
- Narrative synthesis suggested clinically relevant improvements, particularly with programs combining resistance, aerobic, and functional training.
Why it matters
Upper limb dysfunction can affect hand function in adults with type 2 diabetes, including those with DPN. The review highlights a possible role for combined rehabilitation approaches, while the pooled estimates do not establish clear benefits for strength or dexterity. This distinction helps frame the evidence as promising but uncertain and underscores the need for better targeted evaluation.
What to keep in mind
Overall study quality was predominantly moderate, with substantial heterogeneity. Only four included studies involved people with DPN, limiting DPN-specific conclusions.