Effectiveness of Proprioceptive Neuromuscular Facilitation Stretching versus Pedocycle on HbA1c level and quality of life among Diabetic Neuropathy—A Pilot Study

STUDY DESIGN: Pilot Study

STUDY AREA:  Tarawati Charitable Foundation Mandawali East Delhi

STUDY POPULATION:  Diabetic neuropathy with specific age range (45 to 65 years and include both male and female)

SAMPLING TECHNIQUE: Random Sampling

**SAMPLING SIZE:**36 [10 in each group + 2 subjects added extra in each group]

SELECTION CRITERIA OF PATIENTS:

INCLUSION CRITERIA

1. Subject age under 45 to 65 years.

2. Subject having an HbA1c level equal to or more than 6.5 percent.

3. Subject having a history of diabetes for more than 7 years.

4. At least 2 symptoms of diabetic neuropathies on the MNSI questionnaire subject included in the study.

5. Score greater than 1 point on a 10-point scale for physical assessment according to the MNSI instrument.

Exclusion

1. Avoid those subjects who go to the gym or yoga classes.

2. Last 6 months recent surgery.

3. Suffer from any severe condition like cancer or TB.

4. Last 6 months any upper or lower limb fracture.

5. Subject who has a foot ulcer or deformity.

STEP 1:

A total no. [N] = 36 subjects will be enrolled in the study according to inclusion and exclusion criteria, 10 in each group, and 2 will be added extra in each group. If the subject leaves in the middle, then 2 subjects are included extra in each group. Prolonged diabetes for more than 7 years. The Michigan Neuropathy Screening Instrument (MNSI) is a tool used to check the questionnaire and physical examination. On this basis, select the diabetic neuropathy patient. Consent must be taken prior to making them part of the study.

STEP 2:

Participants dividing into 3 groups. Group A (1 intervention: PNF stretching upper limb and lower limb), Group B (2 interventions: pedocycle), and Group C (3 control: no intervention will be given to this group) of 12 subjects in each group. The intervention will be explained in the participant consent form.

STEP 3:•  Pre- assessment

1.  HbA1c test: measures average reading.

2. MDQOL-17 Questionnaire = Quality of life

3. MNSI scoring

STEP 4:

[Group A] PNF stretching to upper and lower limbs follows D1, D2, D3, and D4 patterns.

1. 3 days a week for 6 weeks.

2. Each pattern of stretch is held in position for 30 secs.

3. Between each repetition, provide 15 seconds of relaxation.

4. Between each pattern, provide 30 seconds of relaxation.

5.4 repetitions of each pattern.

6. Every 2 weeks add 4 repetitions.

[Group B] Pedocycling

1. Warm up and cool down.

2. 5 min of pedocycling.

3. During pedocycling, 60 percent of maximum heart rate should be maintained.

4. 3 sessions a week for 6 weeks.

5. Every 2 weeks, add in 5 minutes of pedocycling.

[Group C] Control Group

1. We are not providing any physiotherapy intervention.

2. We only need to check the outcomes at the beginning (baseline).

3. And again, check the outcomes at the end (post-assessment) in a normal way.

STEP 5: After 6 weeks outcome measure

1.  HbA1c test: measures average reading.

2. MDQOL-17 Questionnaire = Quality of life

3. MNSI scoring