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Table 3 Intervention and follow-up effects of clinical assessment

From: Effects of strengthening, stretching and functional training on foot function in patients with diabetic neuropathy: results of a randomized controlled trial

Diabetic polineuropathy clinical assessment
Instrument Control Group Intervention Group Intervention effect Follow-up effect
  Baseline (a) n = 29 12 weeks (b) n = 29 Baseline (c) n = 26 12 weeks (d) n = 26 24 weeks (e) n = 26 Effect size or median difference (CI 95%)b-d Effect size or median difference (CI 95%)b-d
MNSI questionnaire (score) a 6 (3) 6 (3) 6¶§ (2) 4 (3) 4 (2) 0.52 (medium) 0.54 (medium)c-d
  0.54 (medium)c-e
MNSI physical assessment (score) b 4.5 (3; 6.5) 5.5 (2.5; 7) 4.5 (3.0; 6.5) 4.0§ (4.0; 5.0) 5.0§ (5.0; 5.5) -1.5 [-2.8 a -0.2] -0.5 [-1.7 a 1.7]c-d
  0.5 [-0.7 a 1.7]c-e
ABC questionnaire (% of confidence) c 78 (18) 78 (19) 84 (16) 86§ (8) 89§ (8) 0.50 (medium) 0.34 (small)c-d
  0.21 (small)c-e
Muscle function d
Extensor digitorum longus and brevis 3.5* 4.0 4.0 4.0 4.0§ 0.0 [0.0 to 0.0] 0.0 [0.0 to 0.0]c-d
  (3.0; 4.0) (3.0;5.0) (3.3;5.0) (4.0;4.0) (3.0;4.0)   0.0 [0.0 to 0.0]c-e
Extensor hallucis longus and brevis 4.0 4.0 4.0 4.0 4.0 0.0 [0.0 to 0.0] 0.0 [-0.5 to 0.5]c-d
  (4.0;5.0) (4.0;5.0) (4.0;5.0) (4.0;5.0) (4.0;4.0)   0.0 [-0.5 to 0.5]c-e
Flexor digitorum brevis 4.0 4.0†‡ 4.0 5.0 4.0 -1.0 [-1.0 to -1.0] 0.0 [-0.5 to 0.5]c-d
  (4.0;5.0) (3.0;5.0) (3.0;5.0) (4.0;5.0) (4.0;4.0)   0.0 [-0.5 to 0.5]c-e
Flexor hallucis brevis 4.0 4.0 4.0 4.0 4.0 0.0 [0.0 to 0.0] 0.0 [0.0 to 0.0]c-d
  (3.0;5.0) (3.3;4.8) (4.0;5.0) (4.0;5.0) (4.0;4.0)   0.0 [0.0 to 0.0]c-e
Lumbrical 4.0 3.0 4.0 4.0§ 3.5§ -1.0 [-1.5 to -.05] 0.0 [-0.9 to 0.9]c-d
  (3.0;5.0) (2.0;5.0) (2.0;5.0) (3.0;4.8) (2.3;4.0)   0.5 [-0.4 to 0.4]c-e
Interosseous 3.5 3.0 4.0 4.0‡§ 3.0§ -1.0 [-1.5 to -0.5] 0.0 [0.5 to 1.5]c-d
  (2.0;4.0) (2.0;4.0) (2.0;5.0) (3.0;4.0) (3.0;3.0)   1.0 [0.5 to 1.5]c-e
Tibialis anterior 4.5 4.0 4.0 5.0 4.0 -1.0 [-1.0 to -1.0] 0.0 [-0.5 to 0.5]c-d
  (3.0;5.0) (4.0;5.0) (4.0;5.0) (4.0;5.0) (4.0;4.0)   0.0 [-0.5 to 0.5]c-e
Triceps surae 5.0 5.0 5.0 5.0 5.0 0.0 [0.0 to 0.0] 0.0 [0.0 to 0.0]c-d
  (4.0;5.0) (4.0;5.0) (4.0;5.0) (5.0;5.0) (4.0;5.0)   0.0 [0.0 to 0.0]c-e
Functional tests e
Ankle flexion 3.5 3.0 4.0 4.0‡¶# 3.0 1.0 [0.5 a 1.5] 0.0 [-0.4 a 2.4]c-d
  (1.0;4.0) (1.0;4.0) (1.0;4.0) (3.0;4.0) (1.0;4.0)   1.0 [-0.4 a 2.4]c-e
Ankle extension 4.0 4.0 4.0¶§ 4.0 4.0§ 0.0 [0.0 a 0.0] 0.0 [0.0 a 0.0]c-d
  (4.0;4.0) (4.0;4.0) (4.0;4.0) (4.0;4.0) (4.0;4.0)   0.0 [0.0 a 0.0]c-e
Toes flexion 4.0 3.5 4.0¶# 4.0‡¶ 4.0 0.5 [0.0 a 1.0] 0.0 [-0.5 a 0.5]c-d
  (3.0;4.0) (3.0;4.0) (3.0;4.0) (4.0;4.0) (4.0;4.0)   0.0 [-0.5 a 0.5]c-e
Toes extension 4.0* 4.0 4.0 4.0‡¶§ 4.0§ 0.0 [0.0 a 0.0] 0.0 [0.0 a 0.0]c-d
  (3.3;4.0) (4.0;4.0) (4.0;4.0) (4.0;4.0) (4.0;4.0)   0.0 [0.0 a 0.0]c-e
  1. *differences between baselines (p < 0.05).
  2. differences between baseline and 12 weeks for the control group (p < 0.05).
  3. two different conditions from each other (p < 0.05).
  4. §different conditions from each other between follow-up comparisons (p < 0.05).
  5. differences between baseline and 12 weeks for the intervention group (p < 0.05).
  6. amean and standard deviation; maximum score of 13 (symptoms of DPN).
  7. bmedian and interquartile interval; maximum score of 10 (tactile and vibration sensitivity, calcaneal reflex and foot inspection).
  8. cmean and standard deviation; maximum of 100% (% of confidence referred by the patients).
  9. dmedian and interquartile interval; muscle function test gradation (Kendall et al., 2005):
  10. 5:holds test position against maximal resistance.
  11. 4:holds test position against moderate resistance.
  12. 3:holds test position against gravity.
  13. 2:able to move through full ROM with gravity eliminated.
  14. 1:no visible movement, palpable or observed tendon prominence/flicker contraction.
  15. 0:no palpable or observable muscle contraction.
  16. eClassification of foot function (Palmer and Epler, 1990):
  17. 4:normal functionality.
  18. 3:reasonable functionality.
  19. 2:little functionality.
  20. 1:absent functionality.