A Comparative study to find the Effectiveness of PNF and Simple Balance Training to Improve Dynamic Balance in Diabetic Neuropathy

INTRODUCTION: Diabetic Neuropathy plays a significant role in falling among elderly patients. People with peripheral neuropathy caused by diabetes often experience balance disorder, postural sway in these patients is increased, especially with the eyes closed. Peripheral neuropathy caused by diabetes causes significantly impaired sensation in the feet, reducing patients ability to control their balance properly during daily activities. Poor balance can be due to proprioception impairment. Balance problems are also caused by movement strategy impairment, biomechanical structural disorders and disorientation. AIM OF THE STUDY: The aim of the study is to compare the effectiveness of Proprioceptive Neuromuscular Facilitation and Simple Balance Training to improve Dynamic Balance in Diabetic Neuropathy. Need for the study: Very few studies have been conducted to show the effects of balance training in diabetic neuropathy. METHOD: Sample size: 30 patients. Group A - Proprioceptive Neuromuscular Facilitation , Group B - Simple Balance Training. Inclusion Criteria: Age group 50-70 years, Diabetic, Michigan Neuropathy Screening Instrument score >7 to >4. Exclusion Criteria: Foot ulcers, Vision impairment, History of dizziness, Internal otitis ( Labrynthitis), Any other vestibular diseases, Musculo-skeletal disorders, Rheumatic disorders, Total/ Partial amputation of lower extremities, Fractures, History of spinal injury/ surgery, History of lower limb surgery. Evaluation of Diabetic Neuropathy: Michigan Neuropathy Screening Instrument. Procedure: Group A: PNF techniques; 1. Rhythmic initiation, 2. Sustain-Relax, 3. Reversal of Antagonists. Protocol: 1st week - 10 Repetitions. 2nd week - 2 sets of 10 Repetitions. 3rd & 4th week - 3 sets of 10 Repetitions. Duration: 40 minutes. 5 days per week for 4 weeks. Group B: Simple Balance Training; Protocol: 1. Walking training section, 2. Balance training section, 3. Muscle strength training section. Duration: 40 minutes, 5 days per week for 4 weeks. Variables: The 3m Timed up and go test, The Functional Reach test. CONCLUSION: Going by the results of the analysis, we see that both the PNF and Simple Balance Training exercises are individually effective in increasing the scores of FRT and reducing the scores of TUG. That is the scores of all the standard measures (i). FRT are significantly increased (ii). TUG are significantly reduced, due to the either treatments of the PNF and Simple Balance Training. However, by comparing the increase and decrease in scores of standard measures due to these two treatments, it was found that the treatment of PNF is more effective in terms of decreased TUG scores and increased FRT scores. On the whole, we conclude that the PNF is found to be more effective than Simple Balance Training in terms of decreasing the scores of TUG and increasing the scores of FRT in dynamic balance in Diabetic Neuropathy.