Improving postural stability with proprioceptive rehabilitation in patients with diabetic polyneuropathy: a double-blind randomised controlled trial

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Objectives: Postural stability (PS) refers to the ability to maintain balance during various movements. Proprioception deficits in patients with diabetic polyneuropathy (DPN) often lead to significant postural sway and postural unsteadiness during daily activities, increasing fall risk and diminished quality of life. Therefore, this study aimed to investigate the effectiveness of a 12-week proprioceptive rehabilitation programme (PRP) on PS in patients with DPN compared with conventional rehabilitation. Methods: This double-blind randomised controlled trial involved 112 patients with DPN, who were randomly allocated to intervention (n=57) or control (n=55) groups. The intervention group received PRP three times per week for 12 weeks whereas the control group received a conventional balance and strength training programme (BSP) for the same duration. PS scores and anterior-posterior (AP) sway angle were measured under six conditions of the Clinical Test for Sensory Interaction on Balance test at baseline and post intervention. Results: Following the 12-week PRP, PS scores significantly improved in the intervention group by 67.31%-187.81% across different platform types and visual conditions under the six test conditions. In the control group, the postural stability scores improved only in the eyes-opened condition by 36.45% and 50.05% on firm and foam surfaces. AP sway angle improved by 42.46%-56.84% across all test conditions in the intervention group, whereas in the control group there was no improvement. Conclusion: This novel 12-week PRP had a positive impact on PS of patients with DPN compared with conventional BSP. Future randomised controlled trials may be carried out to examine how PRP affects diverse functional status, varying with difficulty levels.

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