Iranian Journal of War and Public Health

eISSN (English): 2980-969X
eISSN (Persian): 2008-2630
pISSN (Persian): 2008-2622
JMERC
0.5
Volume 17, Issue 3 (2025)                   Iran J War Public Health 2025, 17(3): 261-267 | Back to browse issues page

Print XML PDF HTML Full-Text (HTML)

Ethics code: The study followed the ethical guidelines established by the Institutional Scientific Research Board


History

How to cite this article
Dhanusia S, Bai P, Sahal M, Suganthirababu P, Jayaraj V, Kumar P et al . Effectiveness of Whole-Body Vibrator and Inclined Treadmill in Balance Improvement in Patients with Diabetic Neuropathy. Iran J War Public Health 2025; 17 (3) :261-267
URL: http://ijwph.ir/article-1-1636-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Rights and permissions
1- Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India
* Corresponding Author Address: Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India. Postal Code: 602105 (dhanusiasuresh1798@gmail.com)
Abstract   (872 Views)
Aims: Diabetic neuropathy, present in 50% of diabetic patients, results in loss of sensation, muscle weakness, disturbances in balance, and an increased risk of falling. Balance impairment in diabetic neuropathy requires specific rehabilitation methods. New interventions, such as whole-body vibration and inclined treadmill training, offer interesting alternatives to conventional balance training. This study aimed to identify the effectiveness of whole-body vibration and inclined treadmill training in enhancing balance in patients with diabetic neuropathy.
Materials & Methods: This comparative study was conducted in a clinical private setting. Thirty patients were randomly selected through simple random sampling using the lottery method and were divided into two groups (n=15 each). Group A received whole-body vibration therapy for 25 minutes, four times a week, while Group B participated in inclined treadmill sessions for the same duration. Balance and mobility were assessed using the Berg Balance Scale and the timed up and go test before and after the treatment.
Findings: Participants in the whole-body vibration group demonstrated significantly greater improvements in balance, reflected by a higher mean score of 48.67 on the Berg Balance Scale and a lower average time of 7.00 seconds on the timed up and go test. In contrast, those using the inclined treadmill showed mean scores of 41.27 and 10.00 seconds, respectively. Both differences were statistically significant (p<0.001).
Conclusion: Whole-body vibration and inclined treadmill training significantly improve balance, but whole-body vibration is more effective in enhancing stability and reducing fall risk.
Keywords:

References
1. Abraham MM, Tyng TS, Rekha K, Shanmugananth E, Kiruthika S. Comparison of four screening methods for diabetic peripheral neuropathy in type 2 diabetes mellitus patients: A cross sectional study. Research Journal of Pharmacy and Technology. 2018;11(12):5551-8. [Link] [DOI:10.5958/0974-360X.2018.01010.7]
2. Yıldırım T, Önalan R. What is the role of oxidative stress in the development of diabetic peripheral neuropathy?. Journal of Surgery and Medicine. 2021;5(5):408-11. [Link] [DOI:10.28982/josam.889008]
3. Kalpana R, Kothandaraman K, Anuradha P. Association of peripheral neuropathy with retinopathy in diabetic patients. Indian Journal of Clinical and Experimental Ophthalmology. 2018;4(1):115-9. [Link] [DOI:10.18231/2395-1451.2018.0026]
4. Reyhanoğlu DA, Kara B, Şengün İŞ, Yıldırım G. Biomechanical changes observed in diabetic neuropathy. DOKUZ EYLÜL ÜNIVERSITESI TIP FAKÜLTESI DERGISI. 2018;32(2):167-72. [Turkish] [Link] [DOI:10.5505/deutfd.2018.36449]
5. Manorma MR, RANI A, BUDHORI R, KAUSHIK A. Current measures against ophthalmic complications of diabetes mellitus-A short review. Int J Appl Pharm. 2021;13(6):54-65. [Link] [DOI:10.22159/ijap.2021v13i6.42876]
6. Bansal V, Kalita J, Misra UK. Diabetic neuropathy. Postgrad Med J. 2006;82(964):95-100. [Link] [DOI:10.1136/pgmj.2005.036137]
7. Jannu C, Babu PS, Puchchakayala G, Chandupatla VD. Efficacy of interferential therapy versus transcutaneous electrical nerve stimulation to reduce pain in patients with diabetic neuropathy. Indian J Public Health Res Dev. 2018;9(10):121-4. [Link] [DOI:10.5958/0976-5506.2018.01325.6]
8. Mohi WZ, Shemran KA, Alsaffar Y. Comparison of visfatin and leptin levels in type 2 diabetic patients with and without atherosclerosis. Iran J War Public Health. 2023;15(1):11-5. [Link]
9. Yousif AMA, Sokrab TEO, Tawfik H, Abdelbagi I, Mazin SA, Sharaf R, et al. Patients' perception on benefits of medications for treating diabetic peripheral neuropathic pain. Texila Int J Clin Res. 2017;4(2). [Link] [DOI:10.21522/TIJCR.2014.04.02.Art002]
10. Yagihashi S, Mizukami H, Sugimoto K. Mechanism of diabetic neuropathy: Where are we now and where to go?. J Diabetes Investig. 2011;2(1):18-32. [Link] [DOI:10.1111/j.2040-1124.2010.00070.x]
11. Kumar A, Dharshini D. Effect of vestibular based balance training among diabetic neuropathy patient. CUESTIONES DE FISIOTERAPIA. 2025;54(4):5748-54. [Link] [DOI:10.48047/w0038079]
12. Demirağ H, Hintistan S, Tuncay B, Cin A. Health services determination of diabetes risks of vocational high school students. İNÖNÜ ÜNIVERSITESI SAĞLIK HIZMETLERI MESLEK YÜKSEK OKULU DERGISI. 2018;6(2):25-35. [Turkish] [Link]
13. Jamal A, Ahmad I, Ahamed N, Azharuddin M, Alam F, Hussain ME. Whole body vibration showed beneficial effect on pain, balance measures and quality of life in painful diabetic peripheral neuropathy: A randomized controlled trial. J Diabetes Metab Disord. 2019;19(1):61-9. [Link] [DOI:10.1007/s40200-019-00476-1]
14. Ites KI, Anderson EJ, Cahill ML, Kearney JA, Post EC, Gilchrist LS. Balance interventions for diabetic peripheral neuropathy: A systematic review. J Geriatr Phys Ther. 2011;34(3):109-16. [Link] [DOI:10.1519/JPT.0b013e318212659a]
15. Vasudhevan AS, Sumathi DM, Selvakumar AK, Rajabalaji R. A comparative study of mean platelet volume in diabetic population with and without vascular complication. Indones J Med Lab Sci Technol. 2023;5(1):42-52. [Link] [DOI:10.33086/ijmlst.v5i1.3465]
16. Alwatify SS, Radhi MM. Diabetes self-management and its association with medication adherence in diabetic patients. Iran J War Public Health. 2025;17(1):17-22. [Link] [DOI:10.58209/ijwph.17.1.17]
17. Hadi HS, Enayah SH. RETN gene polymorphisms as a risk factor in diabetic patients with Covid-19 infection. Iran J War Public Health. 2023;15(1):1-9. [Link] [DOI:10.32792/utq/utjsci/v9i2.906]
18. American Diabetes Association. Standards of medical care in diabetes-2011. Diabetes Care. 2011;34(Suppl 1):S11-61. [Link] [DOI:10.2337/dc11-S011]
19. Pasupulati H, Swathi B, Tahseen S, Anwer MS, Sandhya R, Fathima S, et al. An observational study of peripheral neuropathy in diabetes patients on metformin therapy and the role of vitamin b-12 supplementation. Int J Pharm Pharm Sci. 2024;16(12):21-5. [Link] [DOI:10.22159/ijpps.2024v16i12.52405]
20. Jo NG, Kang SR, Ko MH, Yoon JY, Kim HS, Han KS, et al. Effectiveness of whole-body vibration training to improve muscle strength and physical performance in older adults: Prospective, single-blinded, randomized controlled trial. Healthcare. 2021;9(6):652. [Link] [DOI:10.3390/healthcare9060652]
21. Ribeiro TS, Silva EM, Silva IA, Costa MF, Cavalcanti FA, Lindquist AR. Effects of treadmill training with load addition on non-paretic lower limb on gait parameters after stroke: A randomized controlled clinical trial. Gait Posture. 2017;54:229-35. [Link] [DOI:10.1016/j.gaitpost.2017.03.008]
22. Hamed MM, Sayed AA, Naseif NL, Fouad SA. Effect of different treadmill inclination training on postural balance in elderly. Med J Cairo Univ. 2022;90(9):1515-21. [Link] [DOI:10.21608/mjcu.2022.264608]
23. Patel B, Shah C, Shah S. Test-retest reliability of berg balance scale in subjects with diabetic neuropathy: A pilot study. JETIR. 2019;6(6):272-5. [Link]
24. Ahmed GM, Fahmy EM, Elwishy AA, Mounir KM, Zidan FS. Effects of inclined treadmill training on gait and balance in stroke patients. NY Sci J. 2018;11(4):52-6. [Link]
25. Rittweger J. Vibration as an exercise modality: How it may work, and what its potential might be. Eur J Appl Physiol. 2010;108(5):877-904. [Link] [DOI:10.1007/s00421-009-1303-3]
26. Avers D. Functional performance measures and assessment for older adults. In: Guccione's geriatric physical therapy. New York: Elsevier; 2020. p. 137-65. [Link] [DOI:10.1016/B978-0-323-60912-8.00007-5]
27. Waheed A, Azharuddin M, Ahmad I, Noohu MM. Whole-body vibration, in addition to balance exercise, shows positive effects for strength and functional ability in patients with diabetic peripheral neuropathy: A single-blind randomized controlled trial. J Diabetol. 2021;12(4):456-63. [Link] [DOI:10.4103/jod.jod_47_21]
28. Geroin C, Mazzoleni S, Smania N, Gandolfi M, Bonaiuti D, Gasperini G, et al. Systematic review of outcome measures of walking training using electromechanical and robotic devices in patients with stroke. J Rehabil Med. 2013;45(10):987-96. [Link] [DOI:10.2340/16501977-1234]
29. Downs S, Marquez J, Chiarelli P. The berg balance scale has high intra-and inter-rater reliability but absolute reliability varies across the scale: A systematic review. J Physiother. 2013;59(2):93-9. [Link] [DOI:10.1016/S1836-9553(13)70161-9]
30. Stambolieva K, Petrova D, Irikeva M. Positive effects of plantar vibration training for the treatment of diabetic peripheral neuropathy: A pilot study. Somatosens Mot Res. 2017;34(2):129-33. [Link] [DOI:10.1080/08990220.2017.1332585]
31. Kordi Yoosefinejad A, Shadmehr A, Olyaei G, Talebian S, Bagheri H, Mohajeri-Tehrani MR. Short-term effects of the whole-body vibration on the balance and muscle strength of type 2 diabetic patients with peripheral neuropathy: A quasi-randomized-controlled trial study. J Diabetes Metab Disord. 2015;14(1):45. [Link] [DOI:10.1186/s40200-015-0173-y]
32. Paz GA, Almeida L, Ruiz L, Casseres S, Xavier G, Lucas J, et al. Myoelectric responses of lower-body muscles performing squat and lunge exercise variations adopting visual feedback with a laser sensor. J Sport Rehabil. 2020;29(8):1159-65. [Link] [DOI:10.1123/jsr.2019-0194]
33. Torvinen S, Kannus P, Sievänen H, Järvinen TA, Pasanen M, Kontulainen S, et al. Effect of four-month vertical whole body vibration on performance and balance. Med Sci Sports Exerc. 2002;34(9):1523-8. [Link] [DOI:10.1097/00005768-200209000-00020]
34. Zafar T, Zaki S, Alam MF, Sharma S, Babkair RA, Nuhmani S, et al. Effect of whole-body vibration exercise on pain, disability, balance, proprioception, functional performance and quality of life in people with non-specific chronic low back pain: A systematic review and meta-analysis. J Clin Med. 2024;13(6):1639. [Link] [DOI:10.3390/jcm13061639]
35. Ferraro RA, Pinto-Zipp G, Simpkins S, Clark M. Effects of an inclined walking surface and balance abilities on spatiotemporal gait parameters of older adults. J Geriatr Phys Ther. 2013;36(1):31-8. [Link] [DOI:10.1519/JPT.0b013e3182510339]
36. Abdelaal A, El-Shamy S. Effect of antigravity treadmill training on gait and balance in patients with diabetic polyneuropathy: A randomized controlled trial. F1000Res. 2022;11:52. [Link] [DOI:10.12688/f1000research.75806.3]

Add your comments about this article : Your username or Email:
CAPTCHA