Background: Peripheral neuropathy is a major and chronic complication of diabetes mellitus
affecting more than 50% patients suffering from diabetes. There is the involvement of both large and
small diameter nerve fibres leading to altered somatosensory and motor sensations, thereby causing impaired
balance and postural instability.
Objective: The aim of this study is to assess the effects of exercises on posture and balance in patients
suffering from diabetes mellitus.
Methods: Mean changes in Timed Up and Go test (TUGT), Berg Balance Scale and Postural Sway
with eyes open and eyes closed on Balance System were primary outcome measures. RevMan 5.3 software
was used for the meta-analyses. Eighteen randomized controlled trials met the selection criteria
and were included in the study. All the studies ranked high on the PEDro Rating scale. The risk of bias
was assessed by the Cochrane collaboration tool of risk of bias. Included studies had a low risk of bias.
Sixteen RCT’s were included for the meta-analysis.
Results: Results of meta-analysis showed that there was a statistically significant improvement in
TUGT with p≤ 0.05 and substantial heterogeneity (I2 = 84%, p < 0.00001) in the experimental group as
compared to control group. There was a statistically significant difference in Berg Balance Scale scores
and heterogeneity of I2 = 62%, p < 0.00001 and significant changes in postural stability (eyes open heterogeneity
of I2 = 100%, p =0.01 and eyes closed, heteogeneity I2 = 0%, p =0.01). Sensitivity analysis
causes a change in heterogeneity.
Conclusion: It can be concluded that various exercises like balance training, core stability, Tai-Chi,
proprioceptive training, etc. have a significant effect on improving balance and posture in diabetic neuropathy.