Annals of Physiotherapy and Occupational Therapy (APhOT)
ISSN: 2640-2734
Review Article
Comprehensive Rehabilitation in Adults with Diabetic Peripheral
Neuropathy: A Literature Review on Frequency, Intensity, and
Duration Parameters
Abstract
Background: Diabetic Peripheral Neuropathy (DPN) raises the risk of falls by causing sensory loss, balance problems, and motor issues. Rehabilitation programs that focus on balance, strength, gait, and sensorimotor training are widely used. Still, there is little agreement on the best frequency, intensity, and duration for these programs.
Objective: To synthesize available evidence on rehabilitation dosage parameters (frequency, intensity, and duration) from randomized controlled trials investigating comprehensive rehabilitation programs for adults with DPN and their effects on balance and fall risk.
Methods: A structured synthesis was conducted, drawing on randomized controlled trials and systematic reviews. Studies were analyzed for duration, frequency, supervision, adherence, and outcomes related to balance, gait, and fall incidence.
Results: Program durations varied from 4 to 52 weeks, but most participants completed 8 to 12 weeks of rehabilitation. Training usually took place 2 to 3 times per week, and sometimes up to 5 times in more intensive programs. Session lengths and intensity were not always reported, but when they were, sessions lasted 30 to 60 minutes. Programs lasting 8 to 12 weeks with at least 2 sessions per week led to clear improvements in balance and gait. However, only a few studies showed a real decrease in the number of falls.
Conclusion: Research shows that rehabilitation programs lasting 8 to 12 weeks with 2 to 3 sessions per week help improve balance and gait in adults with DPN. While these programs have positive effects, there is no standard way to report how hard the exercises should be. Studies use different measures, such as heart rate percentage, perceived effort, or resistance levels. Future research should focus on measuring and standardizing exercise intensity to find the best approach for preventing falls.
Keywords: Diabetic Peripheral Neuropathy; Rehabilitation; Exercise Dosage; Balance Training; Fall Prevention; Frequency; Intensity; Duration
View PDF
