Comparative Effects of Proprioceptive Training and Swiss Ball Exercises on Balance and Peripheral Neuropathy among Patients with Type 2 Diabetes Mellitus

Abstract

Background: Type 2 diabetic patients may suffer from a condition called diabetic peripheral neuropathy, in which patients suffer from peripheral nerves. Objective: To evaluate the effects of Swiss ball training and proprioceptive training in patients with neuropathy due to peripheral nerve damage in diabetes mellitus. Methodology: A quasi-experimental study was carried out involving 30 individuals diagnosed with diabetic peripheral neuropathy. These participants were selected from the Medical Outpatient Department of the National Hospital Faisalabad and the Faisalabad Diabetic Centre. Only individuals between the ages of 45 and 65 years with a confirmed clinical diagnosis of type 2 diabetes mellitus, as verified using the Michigan neuropathy screening instrument, were included in the study. Those with rheumatoid arthritis, visual and vestibular impairments, non-diabetic peripheral neuropathy, osteoarthritis, uncontrolled high blood pressure, foot ulcers, tumors, fracture or dislocation, thyroid disorders,  fibromyalgia or psychological disorders, history of surgery, neurological impairments, pregnant females, participants with uncontrolled diabetes or those having body mass index greater than 25 were excluded. Participants were selected using a non-probability purposive sampling method. Each intervention was carried out over a period of six weeks, with sessions held three times per week. The Michigan neuropathy screening instrument and the star excursion balance test were used as assessment tools. The independent sample t-test was applied to calculate the difference between the two groups and the paired sample t-test for within-group analysis. Results: Paired sample t-test results for the proprioceptive training group showed a significant improvement in both balance and neuropathy symptoms. (p < 0.001). Results from the paired sample t-test for the Swiss ball exercise group showed a statistically significant improvement (p < 0.001). The independent sample t-test revealed no significant difference in post-intervention neuropathy symptoms between the two groups (p > 0.05). However, a significant difference was in enhancing dynamic balance (p < 0.05), with proprioceptive training showing superior outcomes. Conclusion: The findings suggest proprioceptive training may reduce fall risk and improve functional stability, while Swiss ball exercises continue to be an effective option for managing neuropathic symptoms.