Efeitos de intervenções fisioterapêuticas no manejo da neuropatia periférica diabética: uma revisão de literatura

Abstract

Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus, characterized by structural and functional alterations in nerve fibers that impair mobility, balance, and quality of life, while significantly increasing the risk of falls and ulcers. Given the clinical relevance of this condition, this literature review aimed to analyze the available evidence on the effects of physiotherapeutic interventions, with emphasis on exercise programs, in the management of DPN. A search was conducted in the National Library of Medicine (PubMed) database using the descriptors “diabetic peripheral neuropathy” and “physical therapy,” combined with the boolean operator “and.” The inclusion criteria comprised systematic review articles published in the last five years, in English, and with full-text access. After applying the eligibility criteria, six studies were selected. The proposed physiotherapeutic approaches, their parameters, and reported outcomes were analyzed. The findings demonstrate that multimodal exercise programs — including strengthening, stretching, balance training, gait training, ankle mobility, and functional activities — present positive effects on parameters such as range of motion, plantar pressure peak, static and dynamic balance, gait, and reduction of neuropathic symptoms. However, important gaps remain regarding methodological heterogeneity, lack of standardized protocols, low patient adherence, and limited long-term follow-up, which restrict the generalization of results. It is concluded that physiotherapy, through well-structured exercise protocols, represents a promising strategy for the management of DPN, although more robust studies are needed to confirm its effectiveness in clinically relevant outcomes, such as ulcer prevention and sustained reduction of risk of falls.