Effectiveness Of Aerobic Exercise And Stretching Exercise On Limited Joint Mobility Syndrome In Type Ii Diabetes Mellitus

Abstract

Background:
Limited Joint Mobility Syndrome (LJMS), a common yet under-recognized musculoskeletal complication of Type 2 Diabetes Mellitus (T2DM), leads to stiffness, pain, and restricted movement, particularly in the hands, shoulders, and lower limbs. Its pathogenesis is primarily driven by chronic hyperglycaemia, which promotes collagen glycation and connective tissue rigidity, negatively impacting functional capacity and quality of life.

Objective:
This study aimed to evaluate the effectiveness of aerobic and stretching exercises on joint mobility, pain reduction, and functional performance in individuals with T2DM diagnosed with LJMS.

Methods:
A total of 30 participants (aged 40–60) diagnosed with limited joint mobility syndrome in T2DM were included in this interventional study. A structured physiotherapy intervention program was implemented over 12 weeks, involving aerobic exercise (3 sessions per week, including walking, cycling, and low-impact aerobics) and stretching exercises (targeting hand, wrist, leg, and ankle joints). Outcome measures included the Visual Analogue Scale (VAS) for pain, Step Test to assess functional capacity, Goniometer for joint range of motion (ROM), Prayer Sign and Tabletop Sign to assess limited joint mobility syndrome. Data were analyzed using paired t-tests in Instat software.

Results:
There was a significant reduction in pain as measured by VAS, with the mean score decreasing from 5.6 to 3.33 (p = 0.0001). Step Test performance improved significantly, with test duration increasing from 2.30 to 2.91 minutes (p < 0.0001), step count rising from 44.5 to 68.57 (p < 0.0001), and heart rate decreasing from 128.53 bpm to 122.03 bpm (p = 0.0276). Goniometric assessments showed statistically significant improvements in joint flexion in the MCP joint (p = 0.0322), elbow joint (p = 0.0065), and ankle extension (p = 0.0089). Overall improvements were statistically and clinically significant.

Conclusion:
Aerobic and stretching exercises significantly improve joint mobility, reduce pain, and enhance functional capacity in T2DM patients with LJMS. These findings support incorporating structured physical activity programs into standard diabetes care to mitigate musculoskeletal complications and improve quality of life.