Effects of customized proprioceptive training and balance exercises among diabetic patients

Diabetes mellitus (DM) is a prevalent disease considered to be a Public Health problem, with high social and economic costs¹. Among the clinical complications of DM there are blindness, renal insufficiency, peripheral neuropathy^2,3 and many more. Peripheral neuropathy seems to develop as an autonomic and sensorial disturbance and as a progressive and irreversible motor disease⁴. It can interrupt the afferent and efferent functions of the lower extremities that are responsible for maintaining normal posture and normal walking⁵. As a consequence, proprioception is lost hence balance is lost. Little is known about possible treatment strategies. This study evaluates the effects of a customised training programme on proprioception and balance in diabetic patients.

The present clinical trial was conducted among 20 patients (n=20) referred to K.L.E'S Institute of Physiotherapy who were clinically diagnosed with diabetes and fulfilling the inclusion criteria. Ethical clearance was obtained from the institution. Written informed consent was taken from the participants. The intervention consisted of physiotherapeutic training including proprioceptive and balance exercises (daily over 1 month).

Outcome measures used in the study was Berg Balance scale, Falls Efficacy Scale International & was measured before and after completion of therapy.

After intervention, the subjects showed improved balance (p=0.000) and the FES-I score (p=0.000) which were highly significant.

Results of the study are highly significant and confirmed that approach to balance in diabetes mellitus patients should be customised. Customised Proprioception & Balance training is effective in diabetic patients which (BBS score, p =.0000) reduced risk of falls (FES, p=.000) in diabetics. Findings are being well co related with previous findings of balance and proprioceptive trainings which proved to be effective 1–6.

A customized proprioceptive and balance training programme based on a individual needs and functional limitations can improve proprioception and balance and also decrease the risk of falls.