The impact of biodex balance exercise system (BBS) on clinical outcomes, balance and neural function in patients with diabetic peripheral neuropathy

Abstract Background Diabetic peripheral neuropathy (DPN) affects about half of diabetic Persons. It impairs balance and limits their capacity to function. This research addresses the impact of Biodex Balance Exercise System (BBS) training on nerve function, pain, and balance in DPN workers and non-workers. Methods This study is randomized and controlled. fifty DPN patients (ages 18–65) out of 65 patients screened (15 were excluded, 12 not meeting the criteria and 3 refused to participate) were split randomly into intervention group (IG) including twenty-five patients and control group (CG) including twenty-five patients from physical medicine and rehabilitation clinic. All underwent medical history, clinical examination, nerve conduction tests, and assessment using Douleur Neuropathique 4 (DN4) questionnaire, BBS for stability and fall risk, Berg Balance Scale, 10 m Walk Test and Timed Up and Go Test. IG Patients completed BBS balance training program (twice weekly) for 8 weeks, evaluations were done at baseline and post-training. Results IG and CG show no statistical significance at baseline regarding sociodemographic, balance, gait and nerve conduction parameters. In IG, a statistically significant good response was shown in all clinical outcomes, balance and nerve conduction parameters except amplitudes of sural, peroneal and tibial nerves. After Biodex balance exercises, there was statistically significant improvement among workers regarding clinical outcomes, balance, conduction velocity of peroneal nerve, distal motor latency of tibial nerve and peak sensory latency of sural nerve, while other clinical outcomes, balance and nerve conduction parameters showed no improvement. Among non- workers after Biodex balance exercises, there was significant improvement in Postural stability tests, time up and go test, Sural nerve conduction velocity, Peroneal nerve distal motor latency, while other clinical outcomes, balance and nerve conduction studies parameters showed no statistically significant difference. Conclusions BBS balance training program greatly enhances balance, clinical outcomes and nerve function but not nerves amplitudes. This computer-based balance training could be an effective and reasonable therapeutic method to improve the management of clinical outcomes, balance and nerve damage associated with diabetic peripheral neuropathy.