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this study aims to compare the effects of Otago exercise program and BEAT IT program on balance, gait and quality of life in patients with diabetic peripheral neuropathy.
Limited studies have been conducted to assess gait and quality of life. Most of the studies related to the Otago exercise program conducted in the geriatric population, stroke, Parkinson's, alcoholic neuropathy, chronic inflammatory polyneuropathy, and so on, a few studies conducted on diabetes, however up to the researcher's knowledge its effect on diabetic neuropathy has not been found. Similarly, studies related to the BEAT IT Program conducted in cancer patients and diabetes populations. Hence there is a need for comparative study on Otago exercise program and BEAT IT program to assess balance, gait and quality of life in patients with diabetic peripheral neuropathy
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Otago program | Active Comparator | Participants performed a combination of warm-up, strengthening, balance, and aerobic exercises at home. |
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| BEAT it program | Experimental | Participants performed moderate-intensity aerobic, resistance, balance, and flexibility exercises, along with education on diabetes self-management. The exercises were designed to be completed at home using minimal equipment or household items |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Otago Program | Other | The program included: 5 Strengthening exercises and 12 balance exercises. 30-40 min, 4x/week for 8 weeks. Balance Exercises: Knee bends Backwards walking Walking and turning around Sideways walking Tandem stance (heel toe stance) Tandem walk (heel toe walk) One leg stance Heel walking Toe walk Heel toe walking backwards Sit to stand Stair walking Strength exercises: Knee extensor Knee flexor Hip adductor Ankle planter flexors (calf raises) Ankle dorsiflexors (toe raises) |
| Measure | Description | Time Frame |
|---|---|---|
| 4 Stage Balance Test | The Four Stage Balance Test is a validated measure recommended to evaluate static balance. Four standing positions get progressively harder to maintain.
| 8th week |
| Mini BESTest | This test measures dynamic balance, functional mobility, and gait. The Mini-BESTest, the shortened form of BESTest, contains only 14 different tasks and involves four sub-sections: anticipatory postural adjustments, postural response to external perturbations, sensory orientation, and stability in gait. Two items of Mini-BESTest are assessed bilaterally, but only the lower score was added to the maximum score of 28 points, which results from grading based on a 3-point ordinal scale ranging from 0 (severe balance impairment) to 2 (no balance impairment) (108). Reliability 0.98; Validity 0.65. | 8th week |
| Functional Reach Test | FRT is used to evaluate anticipatory balance which correlates with fall risks. This test measures the margin of stability along with the ability to measure balance during a functional task. Reliability 0.89; Sensitivity 76%; Specificity 34% | 8th week |
| Functional Gait Assessment | The FGA has been validated for the assessment of balance in people with vestibular dysfunction, community-dwelling older adults, patients with stroke, and patients with Parkinson disease. The FGA has good reliability (interrater reliability: intraclass correlation coefficient [ICC]=.74; interrater reliability: ICC=.86 to .93) and internal consistency (Cronbach alpha=.79) | 8th week |
| Norfolk Quality of Life-Diabetic Neuropathy (QOL-DN) questionnaire |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Muneeb khan, PhD | Contact | +92336799611 | muneeb.khan@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Javeria Ghazal, MS | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| THQ hospital | Lahore | Punjab Province | 54500 | Pakistan |
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| BEAT it Program | Other | Strengthening exercises Toe spreading Ankle pump Mini wall squats Slow march in standing Knee with pillow press up Bridging Step up and down on stair 1st step Toe curls Stretching Hamstring stretch Dorsiflexors and planter flexors stretch Quads stretch Biceps stretch Triceps stretch Balance exercises Leg front and back swinging Weight shifting front and back Leg sideways Sideway alternate step Tandem stand Alternate heel toe raises Sessions were performed;
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The Norfolk Quality-of Life Diabetic Neuropathy tool (QOL-DN) has been found to be reliable across many different populations. This comprehensive tool has demonstrated sensitivity to both small and large fiber impairment while also detecting improvements in neuropathy. Intra class Reliability >0.9; Internal Consistency >0.6 |
| 8th week |