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This is a randomized controlled trial aims to evaluate the comparative effect of Pain Neuroscience Education combined with neural mobilization versus neural mobilization alone in patients with diabetic neuropathic pain. This study will Compare pain intensity between intervention groups and assess functional disability outcomes. Furthermore, this will evaluate changes in quality of life and to analyze pain-related beliefs following PNE.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A - Pain Neurosciences Education combined with Neural Mobilization | Experimental | Pain neuroscience education (PNE) will be delivered through structured educational sessions focusing on pain physiology, neural sensitization, and pain modulation. PNE: 20-30 min (weeks 1-2) → 10 min reinforcement (weeks 3-6) Methods: Simple diagrams, patient-friendly metaphors, video demonstrations. Neural mobilization techniques will be applied following standardized neurodynamic principles and patients' tolerance. Target nerves: Sciatic, tibial & common peroneal Technique: Slider neurodynamic mobilization Dosage: 10-15 reps × 2-3 sets | Rest: 30-60 sec between sets Session duration: 15-20 minutes |
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| Group B - Neural Mobilization Alone | Active Comparator | Neural mobilization techniques will be applied following standardized neurodynamic principles and patients' tolerance. Target nerves: Sciatic, tibial & common peroneal Technique: Slider neurodynamic mobilization Dosage: 10-15 reps × 2-3 sets | Rest: 30-60 sec between sets Session duration: 15-20 minutes |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pain Neurosciences Education + Neural Mobilization | Other | In Group A pain neuroscience Education will be given in adjunct with neural mobilization techniques Target nerves: Sciatic, tibial & common peroneal Technique: Slider neurodynamic mobilization Dosage: 10-15 reps × 2-3 sets | Rest: 30-60 sec between sets Session duration: 15-20 minutes PNE: 20-30 min (weeks 1-2) → 10 min reinforcement (weeks 3-6) Methods: Simple diagrams, patient-friendly metaphors, video demonstrations |
| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity | Pain intensity will be evaluated using Numeric Pain Rating Scale | Baseline to week 6 |
| Functional disability | Functional disability will be evaluated using Urdu version of Lower Extremity Functional Scale (LEFS) | Baseline to week 6 |
| Quality of life | Quality of life will be evaluated by World Health Organization Quality Of Life-BREF | Baseline to week 6 |
| Central sensitization | Central sensitization will be evaluated using Central Sensitization Inventory | Baseline to week 6 |
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Inclusion Criteria:
Age ≥ 40 years (WHO 2016 criteria) Diagnosed Type II diabetes mellitus Lower limb neuropathic pain ≥ 3 months Pain intensity ≥ 4/10 on NPRS Able to walk independently and follow instructions
Exclusion Criteria:
Neurological disorders (e.g. stroke, Guillain-Barré) Lumbar disc herniation with radiculopathy Lower limb surgery or spinal fracture within 6 months Active diabetic foot ulcer Diagnosed cognitive impairment or severe infection
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Roshan Farman, MSPT | Contact | +923188108470 | 5012324032@student.iiui.edu.pk | |
| Somiya Naz, PhD scholar | Contact | +923315163093 | somiyanaz@uipt.iiui.edu.pk |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Positive Solution Clinic, Wah Cantt | Rawalpindi | Punjab Province | 46000 | Pakistan |
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2 parallel group; Group A - PNE + Neural Mobilization and Group B - Neural Mobilization Alone
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