Immediate Effects of Foot Massage on Balance Performance in Diabetic Patients with Peripheral Neuropathy

Abstract

Diabetes mellitus is a metabolic disease associated with hyperglycemia, which may lead to abnormal sensation of feet due to peripheral neuropathy (PN) and peripheral arterial disease (PAD). These abnormal conditions lead to loss of plantar cutaneous sensation, movement perception, and soft tissue and joint flexibility, resulting in impaired balance and increased risk of fall. Nowadays, the foot massage is one of the alternative therapies which has been commonly used in this patient population and claimed to help improve sensation of the numb feet. Unfortunately, there is a lack of well-controlled studies regarding the efficacy of foot massage. The objective of this study was to investigate the immediate effects of foot massage on balance performance and other parameters related to balance performance in diabetic patients with peripheral neuropathy by comparing them with those who received the diabetic foot health education. Sixty diabetic patients who had numb feet were randomly assigned into either the treatment group (foot massage) or the control group (health education). All of them were evaluated on Timed up and go (TUG), One leg stance (OLS) and associated outcomes including range of motion of 1^stmetatarsophalangeal, ankle, and knee joints and sensation of foot (Semmes-Weinstein Monofilament Test; SWMT) before and immediately after the 30-minute treatments. The results of the immediate effects of foot massage as compared with health education  were that there were not significantly improved in TUG, OLS, ROM of ankle and knee joints, and SWMT (P > 0.05). However, ROM of 1^stmetatarsophalangeal joint were significantly improved (P < 0.05). In conclusion, foot massage could immediately improve range of motion of 1^stmetatarsophalangeal joints. However, we did not find a significant improvement on balance performance in these patients immediately after the treatments.