PICOS Elements | Eligibility Criteria (Concepts of Interest) | |
Population/ Problem/ Phenomenon | REQUIRED: Humans with clinically-diagnosed T2D and DSPN ○ DSPN is analogous to diabetic peripheral neuropathy and diabetic polyneuropathy ○ Articles fulfilling all criteria—but not specifying the type of clinically-diagnosed diabetes—will be included, since the odds are that most of those patients had T2D NOT REQUIRED (but provides greater accuracy or reliability): DSPN diagnosed using recognized criteria, such as those provided by the ADA [8] or IDF [26] | |
Intervention/ Treatment | REQUIRED: Physical exercise (with information on the type, amount, and duration of exercise performed) NOT REQUIRED (but provides greater accuracy or reliability): Physical exercise sessions supervised by the researchers to ensure conformity of performance and adherence Exercise protocols standardized for all subjects (i.e., precludes personalization that could vary relative exertion) | |
Comparison/ Control | REQUIRED: Includes at least one of the following: ○ No intervention or treatment ○ Planned crossover ○ Other treatment (e.g., dietary modifications, lifestyle counseling, pharmacotherapy, electrical stimulation, etc.) ○ Physical exercise combined with other treatment NOT REQUIRED (but provides greater accuracy or reliability): Control group baseline characteristics highly similar to (i.e., not significantly different from) those of the experimental group | |
Outcome | REQUIRED: Evaluates changes in quantitative measurements of DSPN signs or symptoms (i.e., neuropathic severity) ○ QST to measure decreases in § Vibration perception threshold § Touch sensation (e.g., 10g monofilament, SWM) § Temperature threshold § Pinprick pain sensation § Ankle reflexes ○ Posturography to measure abnormalities in proprioception NOT REQUIRED (but provides greater accuracy or reliability): DSPN signs or neuropathic severity measured using validated clinical instruments or accessory methods recommended by the ADA [8] : ○ Clinical instruments: § Michigan Neuropathy Screening Instrument § Modified Toronto Clinical Neuropathy Scale § Utah Early Neuropathy Scale § Neuropathy Disability Score ○ Accessory methods: § Nerve Conduction Study § Corneal Confocal Microscopy § Skin Biopsy (for Nerve Fiber Density) | |
Study Type | REQUIRED: Randomized and controlled NOT REQUIRED (but provides greater accuracy or reliability): Randomization single- or double-blinded | |
(Report) | Published within the last 8 years(January 1, 2012-April 20, 2020) English language only Snowballing references prohibited Must obtain ≥10 eligible articles for thematic synthesis | |