Effectiveness of Physical Therapy Modalities in Diabetic Neuropathy: A mini-Review

Abstract

Background: The prevalence of Diabetic peripheral neuropathy (DPN) is relatively high among Egyptian patients with type 2 diabetes causing sensory loss, motor deficits, and reduced quality of life. Conventional treatments focus on symptom relief but often fail to address nerve damage. This study aimed to evaluate the effectiveness of electrical stimulation, in improving DPN outcomes.

Methods: Alongside a scoping review of literature, we conducted a randomized, double-blind, placebo-controlled trial at Kafr El-Sheikh University involving 60 DPN patients (aged 55–65 years). Patients were randomized (3:1) into an experimental group (n=45) receiving Neuromuscular Electrical Stimulation (NMES) at 35–50 Hz, 200–300 µs, with 5 cm diameter electrodes on quadriceps and gastrocnemius—for 30 minutes, 3 times/week over 10 weeks, and a control group (n=15) receiving placebo stimulation. Outcomes (nerve conduction velocity [NCV], electromyography [EMG]) were assessed using t-tests.

Results: The experimental group showed significant improvements compared to the control group (all p<0.05), including a 36% increase in sural NCV, a 43% reduction in tibialis anterior EMG amplitude. The control group exhibited no significant changes (p>0.05).

Conclusion: Electrical stimulation, one of physical therapy modalities, significantly improves sensory and motor function in DPN, offering a transformative approach. Long-term studies are needed to confirm durability and scalability.