EFFECTIVENESS OF PNF AND PROGRESSIVE RESISTANCE EXERCISE ON STRENGTHENING AND BALANCE IN PATIENTS WITH DIABETIC NEUROPATHY TYPE

Background: Diabetic neuropathy (DN) is a common complication of Type 2 diabetes mellitus, affecting nearly 50% of patients and leading to muscle weakness, balance impairments, and an increased risk of falls. Exercise-based interventions, particularly Proprioceptive Neuromuscular Facilitation (PNF) and Progressive Resistance Exercise (PRE), have been shown to improve neuromuscular function, but their comparative effectiveness in DN rehabilitation remains underexplored.

Objective: This study aimed to evaluate the impact of PNF and PRE on muscle strength and balance in patients with Type 2 DN, as well as to determine whether a combined intervention yields superior outcomes.

Methods: A quasi-experimental pre-test and post-test study was conducted at People’s Hospital, Bhopal, involving 35 participants aged 40-70 years with clinically diagnosed DN. Participants were assigned to three groups: PNF-only, PRE-only, and a combined PNF+PRE group. Lower limb strength was measured using a handheld dynamometer, while balance stability was assessed via the Berg Balance Scale. Exercises were conducted three times per week for 12 weeks, with intensity progressively increased. Data were analyzed using paired t-tests and one-way ANOVA.

Results: Both PNF and PRE interventions led to significant improvements (p < 0.001) in strength and balance. The PRE group showed greater gains in muscle strength, whereas the PNF group demonstrated superior balance improvements. The combined PNF+PRE group exhibited the most substantial overall improvements, though intergroup differences were not statistically significant in post hoc analysis.

Conclusion: PNF and PRE are both effective rehabilitation strategies for DN patients, with PRE being optimal for strength enhancement and PNF excelling in balance training. A combined approach may offer comprehensive benefits, supporting the integration of both modalities in physiotherapy protocols for improved mobility, fall prevention, and quality of life.