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COMPARISON OF MULTISENSORY EXERCISE AND TIBIAL NERVE MOBILIZATION IN PATIENTS WITH TYPE 2 DIABETIC PERIPHERAL NEUROPATHY
Sponsor: Qurat Ul Ain Ashfaq
Summary
Diabetes mellitus is a chronic metabolic condition characterized by high blood glucose levels due to insufficient insulin production or the body's inability to respond properly to insulin. One of its common complications is diabetic peripheral neuropathy (DPN), which develops when prolonged high blood glucose levels damage peripheral nerves, particularly those in the lower limbs and feet. Patients with diabetic peripheral neuropathy may experience burning pain, tingling, numbness, muscle weakness, and loss of sensation. The condition can also affect balance and walking ability, making daily activities difficult. Reduced sensation increases the risk of unnoticed injuries, foot infections, ulcers, and other serious complications. A randomized controlled trial was conducted involving 38 participants, divided into two groups. Group A received tibial nerve mobilization along with conventional physiotherapy, while Group B received multisensory exercise training along with conventional physiotherapy. According to the abstract, both interventions were delivered for 35 minutes per session, three sessions per week, over four weeks. The aim of this study is to determine the comparison of multisensory exercise and tibial nerve mobilization in patients with type 2 diabetic peripheral neuropathy.
Key Details
Gender
FEMALE
Age Range
40 Years - 60 Years
Study Type
INTERVENTIONAL
Enrollment
34
Start Date
2025-10-20
Completion Date
2026-08-28
Last Updated
2026-11-02
Healthy Volunteers
No
Conditions
Interventions
Tibial nerve mobilization
Tibial nerve mobilization will be administered for 20 minutes as part of a 35-minute treatment session. The intervention included three techniques: remote sliders, local sliders, and tensioners. For remote sliders, the patient was positioned in supine lying with the hip flexed to approximately 90° and the knee extended. Ankle dorsiflexion with eversion was combined with cervical flexion and extension to facilitate proximal and distal neural excursion. For local sliders, the patient remained supine with the hip and cervical spine in neutral and the knee fully extended and stabilized. The therapist supported the heel and forefoot while alternating ankle dorsiflexion with eversion and plantarflexion with inversion. For tensioners, the patient lay supine with the hip flexed and knee fully extended; the therapist progressively elevated the limb to increase hip flexion while applying ankle dorsiflexion with eversion and simultaneous cervical flexion to increase neural tension.
Multisensory Excercise
Participants in the multisensory exercise group received multisensory exercise training in addition to conventional physiotherapy. The session duration was 35 minutes, 3 sessions per week, and for 4 weeks. Warm-up: ankle dorsiflexion and plantarflexion, inversion and eversion, walking at a normal pace, and calf and hamstring stretching. Visual-system exercises: visual-motor coordination, including focusing on a moving target while moving the head from side to side and up and down. The intervention was intended to improve balance, functional performance, and quality of life, while reducing pain associated with diabetic peripheral neuropathy. In conventional treatment, TENS will apply for 5 minutes, with a pulse duration of 150 µs and a frequency of 80 Hz. Ankle range-of-motion exercises: 5 minutes, including dorsiflexion, plantarflexion, inversion, and eversion, with 10 repetitions of the movements.
Locations (1)
PulseCore Physio & rehab centre lahore
Lahore, Pakistan