The effect of proprioceptive training on postural control in people with diabetes: A randomized clinical trial comparing delivery at home, under supervision, or no training

Objective: Analyze postural control in the bipedal position as well as during gait and functional tests in patients with type 2 diabetes mellitus after supervised and unsupervised proprioceptive training. Design: A three-group randomized controlled trial. Setting: Physiotherapeutic Resources Lab, Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo Subjects: Eighty patients with type 2 diabetes allocated to three groups: control, home training, and supervised training. Interventions: The supervised and home training groups performed two weekly sessions of proprioceptive exercises for 12 weeks. The control group was not submitted to any of treatment. Main measures: Bipedal balance, gait, and performance on functional tests were evaluated before and after 12 weeks using the Balance Evaluation Systems Test (BESTest) and the force plate. Results: No significant improvements were found regarding postural control, gait, or performance on the functional tests, as evidenced by the inter-group comparisons of the total BESTest score [control: 90.7 (81.5-92.6); home training: 85.2 (77.8-90.3); supervised training: 88.4 (82.6-91.4), P > 0.05] as well as the tests performed on the force plate (P > 0.05). The clinical effect size of the proposed intervention was less than 0.2, demonstrating no effect for the main outcome variable evaluated by the Sensory Orientation item of the BESTest and by the mCTSIB (pressure plate). Conclusions: The proposed proprioceptive training did not lead to improvements in postural control in patients with type 2 diabetes with no clinical signs of diabetic distal polyneuropathy when analyzed using the BESTest clinical evaluation and a force plate.

Automated summary

Both supervised and home proprioceptive training did not lead to significant improvements in postural control, gait, or performance on functional tests in patients with type 2 diabetes mellitus.