Effectiveness of Core Stability Exercise and Proprioception Exercise on Balance in Subjects with Diabetic Neuropathy- A Randomized Controlled Trial

Abstract

Background and Objectives: Long standing Diabetes Mellitus leads to Diabetic Peripheral Neuropathyin the subjects which alter their daily activities performed. As physical activities are the key elements toprevent the further progress of Diabetes Mellitus. The neuropathy also affects the postural stability leadingto impaired balance and risk of falls in the subjects. The integrated activity of the motor and the sensorysystems play an important role in maintain the postural stability which depends upon the strength of thecore muscles and proper integrated activity of the proprioceptors of the lower limb. The prevalence of theDiabetic Peripheral neuropathy in India is around 10.5% to 32.2%. The Toronto Clinical scoring System isused as a marker to assess the level of neuropathy which has a relation on the stability. Thus, the aim of thestudy is to find the effectiveness of proprioception exercise or core stability exercise on balance in DiabeticPeripheral Neuropathy subjects.Objectives: To assess the effectiveness of core stability exercise on balance in Diabetic Neuropathysubjects.To assess the effectiveness of proprioception exercise on balance in Diabetic Neuropathy subjects.To compare the effectiveness of core stability exercise and proprioceptive exercise on balance in DiabeticNeuropathy subjects.Design: Comparative Randomized Parallel Open Label Study Methods: Eighty subjects between the age 40-60 years were recruited for the study. Written informed consentand institutional ethical clearance was obtained. Demographic data were obtained and subjects were assignedto one of two groups: Group A: experimental group given Proprioception exercise (n=40) and Group B:control group given Core Stability exercise (n=40). The therapy was given for six weeks with three days in aweek and was measured with Berg Balance Scale as an outcome measure at the end of the 6 week protocol.Results: Both the groups showed improvement in the balance according to the Berg Balance Scale. Themean ± SD of pre and post Berg Balance Scale of GROUP A was 37.18 ± 4.81 and 39.41 ± 4.95 respectivelyand that of GROUP B was 36.95 ± 4.27 and 38.55 ± 4.29 respectively. Conclusion: The results showed asignificant improvement within Group A and Group B (P<0.001) but there is no significant improvement between both the groups (P>0.05). Thus thestudy concluded that proprioception exercise and core stability exercise are worthwhile in improving the balance in subjects with diabeticperipheral neuropathy.