3. Physical rehabilitation in diabetes mellitus patients

sensory integration, motor control and manual muscle testing (MMT), range of motion (ROM),

Physical therapists should be aware that diabetic patients are exposed to various risks such as

The importance of different modes of exercises in patients with type 2 diabetes is emphasized by increasing uptake of glucose by muscles, improving utilization, altering lipid levels, increasing high density lipoprotein and decreasing triglyceride and total cholesterol. Thus exercise helps people to overcome disability by preventing, treating and rehabilitating neuromuscular complications like neuropathies, skin break down, foot ulcers, arthritis, other joint pains, frozen shoulder, back pain and osteoarthritis associated with DM [17–20]. Moderate to high levels of different modes of exercises like cardio respiratory fitness exercises, aerobic exercise and progressive resistance exercises are also associated with substantially lower mor-

An effective problem-solving approach exploits historical data and information gathered from a basic screening physical examination in a problem-oriented method to guide further investigation. Subjective assessment is an explanation which describes the patients self-report of their current status in terms of their function, disability, symptoms and history. Problem-oriented assessment forms should be used to record the relevant patient reported data, clinical investigation and physical examination results. Record-keeping is an essential component of patient management. It is used for follow-up and evaluation. Taking a full history of the present condition and its possible risk factors, such as smoking, hypertension, obesity, hyperlipidemia and family history is so imperious. Asking for the other symptoms of neuropathic complications such as numbness, joint pain and muscle weakness will also help to evaluate the

biopsychosocial context, severity and nature of the patients' current DM state [21, 22].

Objective assessment should be done routinely to test and objectify the patient identified problems by using appropriate equipments and outcome measurement tools. In physiotherapy,

balance test, endurance test, ADL test and participation in social affairs.

Figure 3. International Classification of Functioning, Disability, and Health.

bidity and mortality in men and women with diabetes. [11, 12, 15].

infections and bedsores.

170 Diabetes Food Plan

2.2.1. Subjective assessment

2.2.2. Objective measurement
