Investigating the role of backward walking therapy in alleviating plantar pressure of patients with diabetic peripheral neuropathy.

Abstract Objective To investigate the effect of combination therapy of backward walking training and alpha-lipoic acid (ALA) treatment on the distribution of plantar pressure in patients with diabetic peripheral neuropathy (DPN). Design This study is a double-blinded, randomized controlled trial. The test group was treated with combination therapy of backward walking exercise and ALA (ALA for 2wk, backward walking exercise for 12wk), and the control group only received ALA treatment. Setting Clinical and laboratory setting. Participants Patients with DPN (N=60) were divided into the test group (n=30) or control group (n=30). Interventions Backward walking exercise with ALA treatment for the test group; lipoic acid treatment for the control group. Main Outcome Measure Plantar pressure before and after treatment was tested and analyzed with the flatbed plantar pressure measurement system. Results After treatment, peak plantar pressure in the forefoot dropped for both the test and control groups; peak plantar pressure for the test group dropped significantly. Peak plantar pressure in the medial foot slightly increased for the test group, suggesting a more even distribution of plantar pressure in the test group after treatment. Conclusions The combination therapy of ALA and backward walking proved to be more effective than ALA monotherapy. Backward walking also proved to have an ameliorating effect on balance ability and muscle strength of patients with DPN.