Comparative effects of cognitive training with whole-body vibration vs. traditional physiotherapy on balance and plantar sensation in diabetic neuropathy.

BACKGROUND

Physical inactivity and the global prevalence of diabetes increase disability related to diabetic neuropathy. Physiotherapy techniques-such as infrared radiation, laser therapy, ultrasound, electrical stimulation, electromagnetic waves, whole-body vibration, and therapeutic exercises-are widely used to manage symptoms. Cognitive exercises activating the frontal and prefrontal lobes also help address cognitive decline and depressive symptoms. Motor and cognitive training improve balance and functional performance, but the combined effect of whole-body vibration and cognitive exercises on neuropathic symptoms remains unclear.

MATERIALS AND

METHODS

This randomized controlled trial involved 42 diabetic patients aged 40-75 years with moderate peripheral neuropathy. Participants were randomly assigned to three groups: (1) Control receiving routine physiotherapy; (2) Treatment Group 1 performing balance exercises with transcutaneous electrical nerve stimulation (TENS); and (3) Treatment Group 2 receiving whole-body vibration (WBV) combined with cognitive exercises. Interventions were performed over ten sessions in four weeks. Functional balance and plantar tactile sensation were evaluated using the Timed Up and Go (TUG), Functional Reach Test (FRT), and 5.07 monofilament tests. Data were analyzed using repeated-measures ANOVA with Bonferroni post-hoc tests (p < 0.05).

RESULTS

All groups showed significant improvement (P < 0.001), with the greatest gains in Group 2, followed by Group 1.

CONCLUSION

Combining WBV and cognitive exercises yields superior benefits in enhancing plantar sensation and balance in diabetic patients with neuropathy.