Evalulation of Effect of lymph massage and pilates in the treatment of diabetic peripheral neuropathy

Investigating the effect of lymph massage and pilates exercises on leg pain, sense of touch, quality of life, balance, neuropathy symptoms and metabolic markers in diabetic patients with peripheral neuropathy.

A clinical trial with two intervention groups and a control group, with parallel groups, one-blind, randomized, on 48 patients, block method was used for randomization.

This study will be conducted with the voluntary participation of people with diabetic neuropathy in the physiotherapy clinic of the rehabilitation faculty. The sampling is done in the form of convenient sampling. The samples are randomly divided into three groups. The first group is treated with lymph massage, the second group is treated with Pilates exercises, and the control group is also treated with routine foot care. None of the patients know about the groupings and the type of intervention.

Inclusion criteria: having type 2 diabetes, symptoms of peripheral neuropathy in the distal lower limbs, body mass index between 20 and 25, age between 40 and 60 years, duration of diabetes more than 5 years, HbA1c between 6 up to 8. Exclusion criteria: insulin use, having diabetic foot ulcers, pregnancy, radiculopathy, any other treatment for peripheral neuropathy in the past three months, skin infection or any skin disease.

Lymph massage group: In this group, lymph drainage surface massage is performed according to the Vodde technique for 45 minutes per session, 5 sessions per week for 10 sessions. Pilates group: The patients do Pilates exercises for 50 minutes in each session, three sessions every week for 4 weeks. Control group: routine care including foot care training, proper shoes and socks

Leg pain, sense of touch, quality of life, balance, neuropathy symptoms and blood sugar

Participants are placed in one of the three study groups by a simple randomization method with the help of a lottery. The researcher gives a special code or number to each participant. Then he writes down the number of each of them on a small piece of paper or cardboard; Then he pours them into a bag or container and stirs them. Then he takes out the beads one by one, writes down their number, and continues until he chooses a number equal to the sample size. Opaque envelopes are also used to conceal randomization allocation.

None of the participants will know about the type of intervention.