Improving Planter Pressure Distribution Could Reduce the Risk of Fall in Patients with Diabetic Neuropathy

Abstract

Objective: This study aimed at assessing the effectiveness of a task specific training guided by visual biofeedback in improving plantar pressure distribution to decrease risk of fall in individuals with Diabetic Peripheral Neuropathy (DPN). Methods: Thirty-four patients with DPN were included in the study and were randomly assigned into two equal groups. The study group received task specific training and 3-Dimensional terminal biofeedback. The control group received traditional strength training. Three sessions of assessments (pre, post and follow-up after a month) were done for all participants. Training was three times per week for 10 weeks. Berg Balance Scale (BBS) and Functional Reach Test (FRT) were used to assess the dynamic and anticipatory balance in addition to the risk of fall. E-med pedography was used to quantify the Planter Pressure (PP) beneath the hind and forefoot during walking. Results: Significant differences were noted in the BBS and FRT indicating a reduced risk of fall in the study groups. PP has been significantly changed in the study group and between the groups. Post-hoc test showed non-significant differences between the second and third measurements of the BBS, FRT and PP within the study group indicating along lasting effect of the applied treatments (p < 0.05). Conclusions: Task specific training and biofeedback may reduce the risk of fall by improving planter pressure distribution in individuals with DPN.