Effectiveness of Lower Extremity Weight Bearing Training along with the Conventional Training to Improve Balance, Vibration Perception and Ankle Mobility in Diabetic Peripheral Neuropathy Patients: A Quasi Experimental study

BACKGROUND: Diabetic peripheral neuropathy (DPN) is a condition which challenging the quality of life of the patients. According to the world health organization report, 108 million persons had diabetes during 1980s; 422 million persons had diabetes in the year 2014. The global prevalence of diabetes has nearly doubled since 1980, rising from 4.7% to 8.5% in the adult population. Mostly the diabetic patients are sedentary in their life style, inactivity contribute the deconditioning of the skin, uncontrolled hyperglycemia and lowering the tolerance for weight bearing activities. Historically these patients are advised to avoid more stress to the plantar tissues to avoid foot ulceration, but moderate lower extremity weight bearing exercises help to improve the patient mobility without increase the risk of foot ulcers. A progressive program may preserve the lower extremity muscles, improve sensory perception and functional balance. AIM AND OBJECTIVE: To study the effect of lower extremity weight bearing training along with conventional training on static balance using sharpen Romberg test, on dynamic balance using TUG test, on vibration perception using biothesiometer and active range of motion using universal goniometer among Diabetic peripheral neuropathy patients. METHODOLOGY: Quasi-experimental research design with purposive sampling technique was employed. 300 Type 2 diabetic patients were selected. Patients who have diabetic history more than 10years, age between 40-65 years, MNSI score >2 and vibratory perception between 15-50V were included. Thirty patients fulfilled the inclusion criteria and they were randomly allocated in to two group. Group A (Experimental) received Lower extremity weight bearing training along with conventional training and group B (control) received the same conventional training alone. Post-test measures of thirty patients were taken after 8 weeks of treatment. OUTCOME MEASURES: Static balance using sharpen Romberg test, dynamic balance using TUG test, Vibratory perception using biothesiometer and Active range of motion using Universal goniometer are used. RESULTS: The data was analyzed using ‘t’ test at 5% level of significance. The homogeneity is maintained between two groups. The experimental group that receive Lower extremity weight bearing training along with conventional training had significant improvement in both static balance (t stat=26.89), dynamic balance (t stat=27.8), vibration perception in right foot (t stat=12.07), left foot (t stat=16.74) and active ankle range of motion than the control group that receive only conventional training. CONCLUSION: The results of this study conclude that lower extremity weight bearing training enhance balance both static and dynamic, vibration perception and active ankle range of motion among diabetic peripheral neuropathy patients