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Mahrukh Asghar
Iqra Rasheed
Rajesh Kannan Karuppaiyan
Saud Ahmad Khan
Muhammad Sharyar
Sana Amjad
Hanan Azfar


Diabetic Peripheral Neuropathy, Vibration Footwear, Dynamic Balance, Gait Ability, Neuropathic Symptoms, Randomized Clinical Trial, Mobility Intervention.


Background: Diabetic peripheral neuropathy (DPN) is a prevalent complication of diabetes, leading to impaired sensory function and increased risk of falls. This study investigates the potential benefits of vibration footwear in individuals with DPN, aiming to address gaps in understanding the effects on dynamic balance, gait ability, and neuropathic symptoms.

Objective: To assess the impact of vibration footwear applied during the gait cycle on dynamic balance and gait ability in individuals with diabetic peripheral neuropathy.

Method: A randomized clinical trial was conducted with 60 participants diagnosed with DPN, divided into intervention and control groups. Baseline assessments included demographic data, baseline characteristics, and neuropathic symptoms. The intervention group wore vibration footwear, while the control group used standard footwear. Follow-up assessments included objective biomechanical data, patient-reported outcomes, and adherence measures.

Results: The intervention group demonstrated significant improvements in dynamic balance and gait ability, as evidenced by reduced Timed Up and Go Test times and increased gait speed compared to the control group. Neuropathic symptoms also decreased significantly in the intervention group. Adherence to vibration footwear was high, although not statistically different from the control group.

Conclusion: Vibration footwear shows promise as a therapeutic intervention for enhancing mobility and reducing neuropathic symptoms in individuals with diabetic peripheral neuropathy. The results emphasize the potential positive impact of this intervention on the overall well-being and functional mobility of individuals facing the challenges of DPN.

Abstract 157 | PDF Downloads 65


1. Leonard DR, Farooqi MH, Myers S. Restoration of sensation, reduced pain, and improved balance in subjects with diabetic peripheral neuropathy: a double-blind, randomized, placebo-controlled study with monochromatic near-infrared treatment. Diabetes care. 2004;27(1):168-72.
2. Lavery LA, Murdoch DP, Williams J, Lavery DC. Does anodyne light therapy improve peripheral neuropathy in diabetes? A double-blind, sham-controlled, randomized trial to evaluate monochromatic infrared photoenergy. Diabetes care. 2008;31(2):316-21.
3. Roth T, van Seventer R, Murphy TK. The effect of pregabalin on pain-related sleep interference in diabetic peripheral neuropathy or postherpetic neuralgia: a review of nine clinical trials. Current medical research and opinion. 2010;26(10):2411-9.
4. Lee K, Lee S, Song C. Whole-body vibration training improves balance, muscle strength and glycosylated hemoglobin in elderly patients with diabetic neuropathy. The Tohoku journal of experimental medicine. 2013;231(4):305-14.
5. Najafi B, Crews RT, Wrobel JS. A novel plantar stimulation technology for improving protective sensation and postural control in patients with diabetic peripheral neuropathy: a double-blinded, randomized study. Gerontology. 2013;59(5):473-80.
6. Najafi B, Khan T, Fleischer A, Wrobel J. The impact of footwear and walking distance on gait stability in diabetic patients with peripheral neuropathy. Journal of the American Podiatric Medical Association. 2013;103(3):165-73.
7. Najafi B, Talal TK, Grewal GS, Menzies R, Armstrong DG, Lavery LA. Using Plantar Electrical Stimulation to Improve Postural Balance and Plantar Sensation Among Patients With Diabetic Peripheral Neuropathy: A Randomized Double Blinded Study. Journal of diabetes science and technology. 2017;11(4):693-701.
8. Kang GE, Zahiri M, Lepow B, Saleem N, Najafi B. The Effect of Daily Use of Plantar Mechanical Stimulation Through Micro-Mobile Foot Compression Device Installed in Shoe Insoles on Vibration Perception, Gait, and Balance in People With Diabetic Peripheral Neuropathy. Journal of diabetes science and technology. 2019;13(5):847-56.
9. Horstink KA, van der Woude LHV, Hijmans JM. Effects of offloading devices on static and dynamic balance in patients with diabetic peripheral neuropathy: A systematic review. Reviews in Endocrine and Metabolic Disorders. 2021;22:325-35.
10. Cham MB, Mohseni-Bandpei MA, Bahramizadeh M, Forogh B, Kalbasi S, Biglarian A. Effects of vibro-medical insoles with and without vibrations on balance control in diabetic patients with mild-to-moderate peripheral neuropathy. Journal of biomechanics. 2020;103:109656.
11. Jamal A, Ahmad I, Ahamed N, Azharuddin M, Alam F, Hussain ME. Whole body vibration showed beneficial effect on pain, balance measures and quality of life in painful diabetic peripheral neuropathy: a randomized controlled trial. Journal of Diabetes & Metabolic Disorders. 2020;19:61-9.
12. Ravanbod R, Eslami N, Ashtiani MN. Immediate effects of footwear with vibration applied to the swing phase of the gait cycle on dynamic balance in patients with diabetic peripheral neuropathy. Journal of biomechanics. 2021;128:110710.
13. Khan MT, Shareef F, Farooq U, Tahir A. Impact of Facility Characteristics on Patient Safety, Patient Experience, and Service Availability for Procedures in Hospitals. Pakistan Journal of Rehabilitation. 2022;11(1):136-44.
14. Makki ARK, Tahir M, Amin U, Tabassum MMB, Kamran M, Tahir F. Mechanism of Meniscal Injury and its Impact on Performance in Athletes: Meniscal Injury in Athletes. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2022;2(3):232-7.
15. Malik J, Farooq U, Tahir M, Ayyaz A, khalid Makki AR. Impact of Attending Online Classes on Mental Health Among University Students During COVID-19 Pandemic in Lahore: Impact of Online Classes in Covid-19. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2022;2(2):162-9.
16. Monteiro RL, Ferreira JS, Silva ÉQ, Cruvinel-Júnior RH, Veríssimo JL, Bus SA, et al. Foot–ankle therapeutic exercise program can improve gait speed in people with diabetic neuropathy: A randomized controlled trial. Scientific reports. 2022;12(1):7561.
17. Tahir A, Fatima A, Khan MT. Association of depression in patients with fibromyalgia syndrome. Pakistan Journal of Rehabilitation. 2022;11(1):174-83.
18. Asghar M, Safdar Z, Tahir M. Quality of life and functional Outcomes among Burn Patients: A Cross Sectional Survey. Journal of Health and Rehabilitation Research. 2023;3(2):293-8.
19. Khalil SHA, Deeb HMAE, Ajang MOD, Osman NA, Amin NG. Impact of diabetic peripheral neuropathy on gait abnormalities in patients with type 2 diabetes mellitus. Diabetology International. 2023:1-9.
20. Safdar Z, Asghar M, Tahir M. Level of Quality of Life among Post Stroke Patients; A Cross Sectional Survey. Journal of Health and Rehabilitation Research. 2023;3(2):299-304.
21. Sharma S, Kalia V. Effect of tibial nerve mobilization on balance & gait functions in subjects with subclinical diabetic neuropathy: A randomized clinical trial. Journal of diabetes and metabolic disorders. 2023;22(2):1283-90.
22. Tahir M, Maqsood M, Azhar N, Safdar Z, Amin U, Waheed TS. Association of Knee Pain in Long Standing and Sitting among University Teachers: Association of Knee Pain in University Teachers. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2023;3(1):314-21.
23. Tahir M, Tariq F, Saeed HW, Nauman M, Usman M, Ali S. Impact of Air Pollution on Respiratory Health of Traffic Wardens in Lahore: Air Pollution and Respiratory Health. The Healer Journal of Physiotherapy and Rehabilitation Sciences. 2023;3(7):703-9.
25. Omer A, Moghadam BA, Shadmehr A, Hafeez T, Azfar H, Arif M, et al. Effects of Kinesio Taping and Modified Constraint-Induced Movement Therapy on Upper Extremity Function, Quality of Life, and Spasticity in Individuals Recovering from Stroke. Journal of Health and Rehabilitation Research. 2024;4(1):167-72.
26. Giri HS, Borkar P. Effects of sensory stimulation on balance and postural control in diabetic neuropathy: systematic review. International Journal of Research in Medical Sciences. 2021;9(7):2090.
27. Franz A, Rickert G, Ko M. Immediate Effects of Acute Postural Correction on Plantar Pressures and Gait Characteristics in an Individual with Diabetic Peripheral Neuropathy: A Case Report. J Nov Physiother. 2013;3(152):2.
28. Hatton AL, Gane EM, Maharaj JN, Burns J, Paton J, Kerr G, et al. Textured shoe insoles to improve balance performance in adults with diabetic peripheral neuropathy: study protocol for a randomised controlled trial. BMJ open. 2019;9(7):e026240.
29. Monteiro RL, Ferreira JS, Silva ÉQ, Donini A, Cruvinel-Júnior RH, Verissímo JL, et al. Feasibility and preliminary efficacy of a foot-ankle exercise program aiming to improve foot-ankle functionality and gait biomechanics in people with diabetic neuropathy: A randomized controlled trial. Sensors. 2020;20(18):5129.
30. Mustapa A, Justine M, Mohd Mustafah N, Jamil N, Manaf H. Postural control and gait performance in the diabetic peripheral neuropathy: a systematic review. BioMed research international. 2016;2016.
31. BHATT U, MEHTA M, KUMAR GP. Postural Control in Diabetic Peripheral Neuropathy: A Narrative Review. Journal of Clinical & Diagnostic Research. 2022;16(4).
32. Yamasaki H, Abe Y, Mima S, Bando M, Nagasaka S, Yamashita Y, et al. Effect of joint limitation and balance control on gait changes in diabetic peripheral neuropathy. Diabetology International. 2023;14(4):390-6.

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