Exercise is a well-established method for reducing HbA1c in patients with DM.
8 The American Diabetic Association (ADA) recommends 150 minutes of both aerobic exercise and resistance training per week; thus, improving patient mobility should be the goal of physicians caring for patients with DM.
9 Two recent literature reviews by Shubrook et al
10 and Johnson et al
11 showed that lifestyle interventions, including the ADA's recommendations on exercise, significantly reduced incidence of DM and progression of prediabetes to DM. Decreasing a patient's pain sensitivity may play an important role in exercise completion by affecting patient exercise confidence and tolerability.
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Research has shown that OMT can be of benefit in the previously mentioned MSK disorders such as carpal tunnel and adhesive capsulitis. A 2018 systematic review
13 on knee OA found that OMT with and without exercise resulted in reduced pain, increased function, increased physical performance, and a short-term benefit in range of motion with studies showing an effect ranging from 3 weeks to 1 year. A systematic review
14 of shoulder conditions showed moderate-quality evidence to support OMT alone or in combination with exercise over the short- and long-term (the follow-up periods varied with each intervention that was analyzed). A 2018 randomized, controlled trial
15 showed significant improvement in overall health status in patients with CTS who received OMT compared with nontreatment controls. Additionally, a review
11 on the role of OMT in DM stated that addressing early tissue restrictions may have an impact on preventing or limiting future MSK complications in patients diagnosed with DM.
Finally, OMT causes a significant reduction in LBP for patients with DM.
16 In 2008, the OSTEOPATHIC Health Outcomes in Chronic Low Back Pain trial
17 evaluated the effect of OMT on LBP using a randomized, double-blinded, sham-controlled design. The results showed a significant pain reduction in LBP with OMT.
17 Additionally, a subgroup analysis
16 from the trial
17 demonstrated a significant decrease in LBP in patients with DM. The subgroup analysis
16 showed the efficacy of OMT on LBP in diabetic patients, and showed a significant increase in the baseline prevalence of somatic dysfunction in patients with DM. Elsewhere, OMT was shown to reduce LBP and was associated with decreased use of analgesics, including nonsteroidal anti-inflammatory drugs, in patients with LBP.
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