Balance interventions for diabetic peripheral neuropathy: a systematic review

Area of Science:

• Neurology
• Physical Therapy
• Diabetology

Background:

• Diabetic Peripheral Neuropathy (DPN) affects over 30% of diabetic patients.
• DPN leads to sensory and motor deficits in lower extremities, causing balance dysfunction.
• There is a lack of systematic reviews on physical therapy interventions for DPN-related balance issues.

Purpose of the Study:

• To systematically review physical therapy interventions for balance dysfunction in Diabetic Peripheral Neuropathy.
• To assess the effectiveness of current physical therapy practices for DPN.

Main Methods:

• Systematic literature search of CINAHL, EMBASE, Cochrane Review, and Medline (up to June 2009).
• Inclusion of studies on balance interventions within physical therapy scope, excluding case reports and systematic reviews.
• Methodological quality assessed using Delphi criteria; 6 articles were included.

Main Results:

• Four interventions were identified: infrared energy, vibrating insoles, lower extremity strengthening, and cane use.
• Lower extremity strengthening exercises received a fair recommendation for clinical use.
• Insufficient evidence was found to support or refute other interventions for DPN balance dysfunction.

Conclusions:

• Lower extremity strengthening exercises are recommended for physical therapists treating balance dysfunction in DPN patients.
• Further research is required to establish the efficacy of other interventions.
• This review highlights the need for evidence-based physical therapy guidelines for DPN.