Efficacy and Safety of Static Stretching and Daily Walking on the Cardio-Ankle Vascular Index in a Patient With Type 2 Diabetes Mellitus, Proliferative Retinopathy, and Lower-Extremity Peripheral Arterial Disease: A Case Report

Proliferative diabetic retinopathy (PDR) and peripheral arterial disease (PAD) of the lower extremities are serious complications of type 2 diabetes mellitus (T2DM). Aerobic exercise has been shown to be primarily effective for glycemic control and gait disturbance owing to PAD. However, the safety and efficacy of exercise therapy in patients with PDR remain unclear. The purpose of this case report was to demonstrate the short-term effects of static stretching (SS) and daily walking over 10,000 steps on patients with T2DM presenting with PDR and PAD. The intervention consisted of 40 minutes of other-movement SS and in-hospital walking during a two-week hospitalization phase and 20-30 minutes of automatic SS and outdoor walking during a two-week home phase post-discharge. The walking conditions consisted of 10,000 steps/day, and the rate of perceived exertion was 11-12 on the Borg scale. Outcomes included the presence of a new intraocular hemorrhage and changes in intraocular pressure (IOP), blood pressure, fasting blood glucose level, biochemical parameters, cardio-ankle vascular index (CAVI), and ankle-brachial index. No new intraocular hemorrhage or increased IOP was observed during the intervention period, and blood pressure, glycemic control, and CAVI parameters improved. The results of the intervention in this case suggest that the combination of SS and walking exercises may be safe and effective.