Effectiveness of Neural Mobilization in improving ankle range of motion and plantar pressure distribution in patients with diabetic peripheral neuropathy: A single group pretest- posttest quasi experimental study

Diabetic peripheral neuropathy is the commonest complication in individuals with type2 diabetes. The severity of neuropathy is seen to be increased along with the duration of diabetes. In previous studies, it was found that ankle mobility is significantly reduced, both dorsiflexion and plantarflexion ranges are affected significantly. Also, the pressure under the different areas of foot is also altered with much higher pressure under certain foot areas which can lead to damage of dermal layers and causing damage and may lead to diabetic ulcers in foot. Neural mobilization is a newer technique which is currently being used for treating Neuro-musculoskeletal conditions and showing good results. In our study, we used neural mobilization to see the effect in improving the ankle mobility and plantar foot pressure distribution in individuals with diabetic peripheral neuropathy. The outcome measures taken was Ankle ROM (Active & Passive) using the universal goniometer and the plantar pressure distribution using Harris mat. The outcome measurements were taken at baseline and at 4 weeks after completion of intervention. For ankle ROM measurements, the participants were taken in siting position. The plantar pressure distribution was taken in dynamic situation where patient was asked to walk on the clear 5 meter path in which Harris mat was placed in between. The procedure was then repeated with another foot.

糖尿病周围神经病变是2型糖尿病患者最常见的并发症。神经病变的严重程度与糖尿病的持续时间呈正相关。在先前的研究中，发现踝关节的活动性显著下降，无论是背屈还是跖屈的范围均受到显著影响。此外，足部不同区域的压力也发生了改变，某些区域的压力显著升高，这可能导致表皮层的损伤，进而引发足部溃疡。神经松动术是一种新兴技术，目前被用于治疗神经肌肉骨骼疾病，并显示出良好的治疗效果。在我们的研究中，我们采用神经松动术以观察其对改善糖尿病周围神经病变患者踝关节活动性和跖足压力分布的影响。所采用的结局指标包括使用通用量角器测量的踝关节活动范围（主动与被动）以及使用哈里斯垫测量的跖足压力分布。结局指标的测量分别在干预前和干预完成后的第4周进行。在踝关节活动范围测量中，参与者被置于坐位。跖足压力分布的测量则在动态情况下进行，患者被要求在铺设有哈里斯垫的清晰5米路径上行走，路径中间放置了哈里斯垫。随后，对另一只脚重复了相同的程序。