Effects of Weight-bearing Exercise on a Mini-trampoline, and Foot-Ankle Therapeutic Exercise Program on Foot-Ankle Functionality in People with Diabetic Peripheral Neuropathy

The purpose of this study is to investigate and compare the efficacy of two training programs of weight-bearing on a mini-trampoline, and ankle exercise therapy on foot-ankle functionality in people with peripheral neuropathy.

The present research is a clinical trial study that has been conducted using two intervention groups and one control group. The statistical population of this study includes 48 women with type 2 diabetes and moderate or severe neuropathy living in Tehran. The Michigan Neuropathy Screening Instrument (MNSI) and Foot Health Status Questionnaire (FHSQ-BR) were used for collecting data. The first experimental group performed mini-trampoline exercises, while the second group performed ankle therapeutic exercises at home for eight weeks. Data were analyzed using analysis of covariance (ANOVA) and correlated t-test.

The findings showed that mini-trampoline exercise and ankle exercise therapy had a significant effect on relieving foot pain (P<0.05), as well as improving foot functionality (P<0.05) and overall foot health (P<0.05) in both intervention groups compared to the control group. Also, the results showed that ankle exercise therapy was more effective than mini-trampoline exercise in two variables of foot pain and foot functionality (p<0.05). Both training programs showed significant effects on the ankle range of motion (p<0.05), while, there was no significant difference between the two intervention groups with respect to the range of motion of the ankle (p<0.05). Moreover, Mini-trampoline exercise and ankle exercise therapy revealed a significant effect on the range of motion of the metatarsophalangeal joints compared to the control group (P<0.05). In the range of motion of dorsiflexion of the right foot, mini-trampoline exercises were more effective than therapeutic exercises, while regarding the variable of dorsiflexion of the left foot, the effectiveness of ankle training intervention was more than that of trampoline (p<0.05). Both trampoline exercise and ankle therapeutic exercise interventions had a significant effect on ankle strength, but there was no difference in plantar flexion strength of the right foot between the two intervention groups. However, the mini-trampoline intervention was more effective than the ankle exercise therapy intervention with respect to the three variables of the hallux dorsiflexion strength of the hallux and plantar flexion strength of the left foot (p<0.05). Both training interventions were effective on the variable of right and left hallux flexion strength (p<0.05). The efficacy of none of the two interventions on the right and left hallux extension strength was confirmed; the effectiveness of both interventions on the right and left hallux flexion strength was similar with no significant difference (P>0.05). No significant difference was found in the control group after 8 weeks with respect to the relevant variables (P>0.05).

Exercises on the mini-trampoline and ankle therapeutic exercises at home can be effective in improving patients' quality of life as a simple, affordable, low-risk and quick-improvement treatment program that focuses on the use of segmental exercises for foot functionality.