Comparative Effects of Balance and Resisted Training in Diabetic Peripheral Neuropathy.

Not Applicable

Completed

Brief Summary: The aim of this study is to determine comparative effects of balance and resisted training on pain and balance in patients with daibetic peripheral neuropathy.

Detailed Description: This randomized clinical trial will be conducted at Mumtaz Bakhtawar Hospital in 7 months after the approval of synopsis. The sample size for this trial will be 58 patients with DPN. Participants those meet inclusion criteria will be randomly allocated into two groups using online randomization tool, 29 participants will be assigned to Group A which will receive Balance training exercises for 35 minutes and Group B will receive Resistance Training exercises for 45 minutes. Each participant will receive intervention for 3 alternate days per week for 8 weeks.

The Michigan neuropathy screening instrument will be used for the assessment of DPN symptoms scores at baseline. Balance will be evaluated using the De Morton mobility index (DEMMI) test, while painDIRECT tool will be utilized to measure pain. The data will be entered and analyzed using SPSS version 24 for windows software.

Recruitment & Eligibility

Inclusion Criteria

Patients diagnosed with DNP with score ≥ 2.5 on Michigan neuropathy screening instrument of both genders.
Age between 40 to 65 years.
Patients having the minimum history of diabetes is 7 years.
History of mild to moderate neuropathy . The patients ability to do resistance and aerobic exercises.

Exclusion Criteria

History of taking anti-inflammatory drugs.
History of recent surgical operations of joints in lower extremities.
Patients suffering from musculoskeletal disorders such as rheumatoid arthritis and myopathy.
Patients having any disability, fracture, or dislocation of at least six months before the study.

Arm && Interventions

Group	Intervention	Description
GROUP A (BALANCE EXERCISES)	Balance exercises	Group A will receive a session of balance exercises for 45 minutes.Treatment session will be given for 3 days per week for 8 weeks.This balance exercise program consist of three phases.Warm-up phase(5 minutes,after warm-up phase 35 minutes balance exercises then cooling phase (5 minutes).
GROUP B (RESISTED EXERCISES)	Resisted exercises	Group B will receive a session of resisted exercises for 45 minutes.Treatment session will be given for 3 days per week for 8 weeks.This resisted exercises program consist of three phases.Warm-up phase(5 minutes,after warm-up phase 35 minutes balance exercises then cooling phase (5 minutes).

Primary Outcome Measures

Name	Time	Method
PainDETECT Tool	8th week	painDETECT scale to detect diabetic neuropathic pain which includes symptom questioning and also the type, severity and the radiation of pain.
Michigan neuropathy screening instrument	8th week	This screening tool consists of two sections: Section A, self-administered by the patient, involves 15 yes/no questions about clinical symptoms, and Section B is based on a clinical evaluation. Positive and negative sensory symptoms, cramps, muscle weakness, foot ulcers, cracks, and amputation are assessed.
De Morton mobility index test	8th week	It consists of 15 items covering a broad spectrum of mobility levels and it has shown satisfactory Clinometric properties (30). In this method, the static balance is measured on one leg and two legs, as well as at the closing of the eyes; on the other hand, the dynamic balance is measured and evaluated when the patient jumps and moves four steps back.

Secondary Outcome Measures

Name	Time	Method

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