Rehabilitation Outcomes in Diabetic Peripheral Neuropathy: An Evidence-Based Physiotherapy Approach for Functional Improvement – Case

Kulsum Akter ¹, Siddiqua Syeda Ummul ¹, Mohammad Fakhruzzaman ², Azharul Islam ³, Md. Jahidul Islam ¹, Md. Manik Ahmed Sumon ⁴, Mahmuda Akter ⁵, Tandra Rani Mukherjee ¹, Saleha Fazal ¹, Asma Islam ⁶*

This study highlights physiotherapy's role in managing Diabetic Peripheral Neuropathy, highlighting significant improvements in pain, balance, and mobility.

Abstract

Background: Diabetic Peripheral Neuropathy (DPN) is a prevalent and debilitating complication of diabetes mellitus (DM), affecting up to 70% of individuals with diabetes. DPN impairs motor and sensory functions, leading to pain, muscle weakness, and functional limitations that severely affect the quality of life. Effective rehabilitation strategies, including physiotherapy, are essential for improving these functional outcomes. Methods: This study assessed the effectiveness of a 12-week evidence-based physiotherapy rehabilitation program designed to improve the functional status of a 48-year-old female patient with DPN. The intervention included Transcutaneous Electrical Nerve Stimulation (TENS), range of motion (ROM) exercises, strengthening exercises, balance training, and gait improvement, administered over 45 physiotherapy sessions. Progress was measured using the Visual Analog Scale (VAS), Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test. Results: Following the 12-week intervention, the patient reported significant improvements in pain reduction, with VAS scores decreasing from 9/10 to 4/10. Sensory function improved from impaired to intact, as assessed through light and deep touch sensation tests. Balance scores on the BBS increased from 22 to 48, indicating substantial gains in stability. Gait speed, measured using the TUG test, improved from 35 seconds to 13 seconds. Additionally, there were marked improvements in ROM, muscle strength, and overall functional abilities. Conclusion: The study demonstrates the effectiveness of a structured physiotherapy rehabilitation program in reducing neuropathic pain and improving functional outcomes in patients with DPN. TENS, combined with exercise-based interventions, significantly enhanced pain management, balance, and gait. Long-term monitoring and continued physiotherapy may further optimize the patient’s functional status and quality of life.

Keywords: Diabetic Peripheral Neuropathy (DPN), Transcutaneous Electrical Nerve Stimulation (TENS), Range of Motion (ROM), Physiotherapy Rehabilitation, Functional Improvement

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