Balance Training in Diabetic Peripheral Neuropathy: A Narrative Review

Diabetes has a very high prevalence and a third of the diabetic population is affected with neuropathy. Moreover, one third of the patients with diabetic peripheral neuropathy (DPN) present with some kind of balance and gait disturbances. The incidence of developing diabetic peripheral neuropathy increases with the chronicity of the disease and poor glycemic control. Around 30% of people with DPN experience muscle weakness, loss of ankle reflexes, and decreased balance, coordination and gait control, thereby, limiting walking and increasing the risk of fall-related injuries. For the present article, a literature search was performed using Google Scholar, Pubmed and Cochrane data bases using the keywords. Articles were searched and reviewed using the narrative approach. This review aims to discuss the pathogenesis and factors associated with DPN, concept of balance and postural control, balance and gait impairment in DPN and exercises used to improve balance and gait parameters. In conclusion, the synthesis of the reviewed studies suggests that balance exercises are feasible and safe, and have the potential to improve balance and gait, consequently, reducing the risk of falls and fall-related injuries. Therefore, balance exercises should be used as a supportive therapy in diabetic peripheral neuropathy patients.