Effects Of Otago Exercise Versus Multisensory Integration Training On Balance And Gait In Elderly With Diabetes

Effects Of Otago Exercise Versus Multisensory Integration Training On Balance And Gait In Elderly With Diabetes

The goal of this clinical trial is to compare the effect of the Otago exercise and Multisensory integration training on balance and gait in the elderly with type 2 diabetes mellitus.

The main question it aims to answer is:

• Is there a significant difference between the effect of Otago exercise and Multisensory integration training on balance and gait in the elderly with type 2 diabetes mellitus? Researchers will compare Otago exercise to Multisensory integration training to know which one has the greatest benefit on balance &gait in the elderly with type2 diabetes.

Participants will be divided into 3 groups; each group takes a certain training program for 8 weeks:

• First group: Otago exercise group plus conventional treatment for neuropathy.
• Second group: Multisensory integration training group plus conventional treatment for neuropathy.
• Third group: control group takes only conventional treatment for neuropathy.

Inclusion Criteria:

1. Ninety elderly Patients of both genders.
2. Their age will range from 65 to 75th.
3. They will be diagnosed with type 2 diabetes for 5 years or more.
4. Patients with mild & moderate neuropathy will be included. (Based on the Toronto scale: -mild (6-8); moderate (9-11)
5. Berg balance between (21 to <50) patients with mild &moderate risk of fall .
6. Time up & go dual task: patient takes longer than 10 sec.
7. HBA1C for these patients was ≥ 6.5% .
8. BMI will range from (18: 29,9 kg/m2).
9. Able to walk independently, with or without assistive devices.

Exclusion Criteria:

1. Any musculoskeletal disorder affecting the lower limb (fracture of the lower limb, tumors, any infection, ligament injuries, foot injuries).
2. Any other neurological disorder influences gait such as (stroke, Parkinson's disease, cerebellar dysfunction, ataxia, vestibular disorders)
3. Any other cardiovascular disease (arrhythmia, cardiac pacemakers).
4. Unstable proliferative retinopathy and visual impairments without correction.
5. Non-diabetic neuropathy (inflammatory, autoimmune disease, infections, tumors, vitamin B12 deficiency, hypothyroidism, alcoholism, injury or pressure on the nerve).
6. The use of medications significantly impacting postural control (e.g., sedatives).
7. Vestibular system and Cognitive disorders.
8. Uncontrolled hypertension.
9. Common peroneal nerve injury.
10. Orthostatic hypotension.