Comparative Effects of Proprioceptive Training and Routine Physical Therapy on Diabetic Peripheral Neuropathy
Condition: Diabetic Neuropathies
MeSH terms: Peripheral Nervous System Diseases; Diabetic Neuropathies
Study type: Interventional

Summary: 
      This project will compare the effects of proprioceptive training with routine physical
      therapy intervention on improving balance and health-related quality of life in individuals
      with diabetic neuropathy. The subjects who met the inclusion/exclusion criteria will be
      allocated for controlled and experimental groups. Subjects will be selected from the
      outpatient clinic of the Department of Physical Therapy. Subjects will be divided randomly
      into two equal groups. The study will be single-blinded. Subjects will be randomized into two
      groups Group A & Group B.Baseline data will be collected then collect data at2nd, 4th Week
      and 8th week.Individuals will be assigned to the intervention group receive proprioceptive
      training and strengthening interventions guided by a physiotherapist for 8 weeks. Session
      will begin with a 5 min pre-exercise warm-up of gentle stretches and will be ended with a 5
      min cool-down of slow walking. Participant should encourage to perform the exercises for at
      least four times a week and home-based exercises for once a day.
    

Detailed description: 
      This project will compare the effects of proprioceptive training with routine physical
      therapy intervention on improving balance and health-related quality of life in individuals
      with diabetic neuropathy. The subjects who met the inclusion/exclusion criteria will be
      allocated for controlled and experimental groups. Subjects will be selected from the
      outpatient clinic of the Department of Physical Therapy. Subjects will be divided randomly
      into two equal groups. The study will be single-blinded. Subjects will be randomized into two
      groups Group A & Group B.Baseline data will be collected then collect data at2nd, 4th Week,
      and 8th weeks.

      FOR CONVENTIONAL PHYSICAL THERAPY GROUPS:

      The control group will receive only strength training intervention included the following
      components:

      Range Of Motion Exercises: movements to the extent possible of the knee (flexion-extension),
      ankle (Dorsi, plantar flexion), forefoot (inversion-eversion), and toe (flexion-extension).

      5 repetitions of each ROM exercise will be done for 2 minutes. Muscle Strengthening
      Exercises: active movements against resistance (using a Thera band) at the knee
      (flexion-extension), ankle (dorsiflexion and plantar flexion), forefoot (inversion-
      eversion), and toe (flexion-extension).

      Each Strengthening exercise will be performed for 5 minutes with 10 repetitions.

      FOR INTERVENTIONAL PHYSICAL THERAPY GROUP:

      The interventional group will receive strengthening intervention as well as proprioceptive
      training for 32 sessions. ROM and Strengthening exercises will be performed the same as in
      the control group.

      Exercises For Proprioceptive Training: Intervention group will practice an additional 24
      minutes of proprioceptive training (two minutes rest prior to performing this training). A
      circuit with different floor textures composed of 6 stations of exercises to stimulate the
      sole of the foot where the participant had to improve gait by stepping with alternate feet
      marker placed on the ground and progression will be done by modifying the speed and
      direction. The material used to build the circuit are in the following order: 10 cm thick
      foam, a wood box with beans, a 2 cm thick mat with density lower than foam, a wooden box
      filled with sand, a balance board to train the lateral balance reactions, a wooden box filled
      with cotton. The duration of this training is 24 minutes; the patient will spend 4 minutes on
      each station
    

Intervention name(s): Conventional Physical Therapy; Conventional Physical Therapy with Proprioceptive Training Exercises
Intervention type(s): Other; Other
Intervention description(s): The control group will receive only strength training intervention included the following components:
Range Of Motion Exercises: movements to the extent possible of the knee (flexion-extension), ankle (dorsi-plantar flexion), forefoot (inversion-eversion) and toe (flexion-extension).
5 repetitions of each ROM exercise will be done for 2 minutes. Muscle Strengthening Exercises: active movements against resistance (using a Thera band) at the knee (flexion-extension), ankle (dorsi-plantar flexion), forefoot (inversion- eversion) and toe (flexion-extension).
Each Strengthening exercise will be performed for 5 minutes with 10 repetitions.; Interventional group will receive strengthening intervention as well as proprioceptive training for 32 sessions. ROM and Strengthening exercise will be performed same as in control group.
Exercises For Proprioceptive Training: Intervention group will practice an additional 24 minutes of proprioceptive training (two minutes rest prior to performing this training). A circuit with different floor texture composed of 6 stations of exercises to stimulate the sole of foot where participant had to improve gait by stepping with alternate feet marker placed on ground and progression will be done by modify the speed and direction. Material used to build the circuit are in following order: 10 cm thick foam, a wood box with beans, a 2 cm thick mat with density lower than foam, a wooden box filled with sand, balance board to train the lateral balance reactions, a wooden box filled with cotton. Duration of this training is 24 minutes; patient will spend 4 minutes on each station.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Diabetes; Diabetic Peripheral Neuropathy; Balance; Quality of Life; Proprioceptive Training; Physiotherapy