Effect of balance training with Biodex Balance System to improve balance in patients with diabetic neuropathy: A quasi experimental study.

Syeda Afsheen Hasnain Daud,Muhammad Junaid,Aatik Arsh,Mujeeb Ur Rahman

doi:10.12669/pjms.37.2.2336

Syeda Afsheen Hasnain Daud, Muhammad Junaid + Show 2 more

Open Access

https://doi.org/10.12669/pjms.37.2.2336

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Abstract

Objective:To determine the effect of balance training with Biodex Balance System in improving balance function in patients with diabetic neuropathy.Methods:A quasi experimental study was conducted at physiotherapy department of Rehman Medical Institute Peshawar from January to June 2018. Thirty-eight Diabetes Mellitus Type-II patients with diagnosis of diabetic neuropathy participated in the study. Those patients were included who were able to stand independently and who scored moderate or severe neuropathy on Toronto Scale. Participants received 12 sessions (two sessions per week) of balance training on Biodex stability system in six weeks. Berg Balance Scale and Time Up and Go test were used to collect pre and post treatment data. Paired sample T-test was used to compare pre and post treatment data because data was normally distributed.Results:The mean age of the participants was 63.08 ± 3.3 years. Pretreatment Berg Balance Scale score was 42.68 ± 3.7 which improved to 48.89 ±3.7 after the treatment (P<0.001). Similarly, pretreatment Time Up and Go test score was 17.47 ± 2.0 while post treatment score was 13.57 ±1.5 (P<0.001).Conclusion:Balance training with Biodex Balance System can significantly improve balance function in Diabetes Mellitus Type-II patients with diabetic neuropathy.

Highlights

Diabetes Mellitus is one of the commonest non-communicable disease, affecting 246 million people worldwide.[1]
In Pakistan the estimated prevalence of Diabetes mellitus (DM) TypeII was 5,217,000 in 2000 and expected to be 13,853,000 in 2030, whereas according to WHO, Pakistan has been ranked 7th in terms of DM prevalence affecting more than 6.9 million of the population and this number is going to be around 11.5 million by the year 2025.1,2 The prevalence of DM in Pakistan was reported to be 7.6% to 11%
Literature suggests that reduction in proprioception and enhanced reflex reaction time are the main causes of poor balance function in diabetic neuropathy patients.[8]

Summary

Introduction

Diabetes Mellitus is one of the commonest non-communicable disease, affecting 246 million people worldwide.[1]. About one third of chronic DM patients with uncontrolled diabetes develop diabetic neuropathy.[5] The exact burden of diabetic neuropathy in Pakistan is unknown, there are reports that 7.5% patients at the time of diagnosis of DM had diabetic neuropathy as well.[6] Previous studies reported that diabetic neuropathy leads to balance impairment, gait abnormalities and postural sway.[7] In clinical settings, postural instability and balance disorders are common findings in diabetic neuropathy patients. Literature suggests that reduction in proprioception and enhanced reflex reaction time are the main causes of poor balance function in diabetic neuropathy patients.[8] Balance dysfunction due to neuropathy adversely affects the quality of life and activities of daily life of DM patients.[9]

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