Feldenkrais vs. Task Oriented Gait Training on Diabetic Peripheral Neuropathy (FEToG-DPN)

Comparative Effects of Feldenkrais Exercises and Task Oriented Gait Training in Patients With Diabetic Peripheral Neuropathy

Diabetic Peripheral Neuropathy (DPN) causes balance problems, falls, and sensory loss in the feet. This study compares two non-drug exercise programs to see which works better. The first program is Feldenkrais exercises, which focus on movement awareness and retraining the brain. The second program is Task Oriented Gait Training, which practices specific walking tasks. Researchers will measure balance, joint position sense, touch sensation, fear of falling, and quality of life. Forty participants will be split into two groups. The study will last 12 weeks.

Study Overview

• Status: Active, not recruiting
• Conditions: Diabetic Peripheral Neuropathy
• Intervention / Treatment: Other: Feldenkrais Exercises; Other: baseline warm up and cool down Exercises; Other: Task Oriented Gait Training

Detailed Description

This study is a single-blinded, randomized clinical trial. Forty participants with Diabetic Peripheral Neuropathy (DPN) will be recruited from Shahid Heera's Health Clinic and Madinah Teaching Hospital in Faisalabad. Participants will be screened using the Michigan Neuropathy Screening Instrument (MNSI). Inclusion criteria include participants aged 45-55 years with type 1 or type 2 diabetes, a history of at least one fall in the past six months, a body mass index between 18.5 and 29.9, controlled blood glucose levels, and a Berg Balance Scale score between 21 and 40. Participants will be excluded if they have foot ulcers, lower leg amputation, Charcot foot, retinopathy, hypertension, or are already receiving rehabilitation.

Eligible participants will be randomly allocated into two groups of twenty using a computer-generated method. Group A will receive Feldenkrais exercises. Group B will receive Task Oriented Gait Training. Both groups will attend two sessions per week for twelve weeks. Each session lasts sixty minutes, consisting of a ten-minute warm-up, a forty-to-forty-five-minute main exercise session, and a ten-minute cool-down. Outcome measures will be recorded at baseline, the sixth week, and the twelfth week. The primary outcome measures are static and dynamic balance (Berg Balance Scale), ankle joint proprioception (joint position sense test), and tactile sensation (monofilament test). The secondary outcome measures are somatosensory postural control (Cumulative Somatosensory Impairment Index), fear of falling (Fall Efficacy Scale), self-awareness learning (educational brochure), and quality of life (SF-36 Questionnaire). SPSS version 20 will be used for statistical analysis.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Faisalābad, Punjab Province, Pakistan, 3800
      • The University of Faisalabad

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age ranges from 45-55 years
• Diagnosed type 1 and type 2 diabetes
• Suffered from a fall in last 6 months
• MNSI Questionnaire scored > 2/13
• MNSI physical assessment scored > 4/10
• BMI = 18.5 - 29.9
• Controlled blood glucose level
• Berg Balance scale = 21-40
• Willingness to participate and provide consent

Exclusion Criteria:

• Presence of ulcers at foot
• Lower leg amputation
• Charcot foot
• Retinopathy
• Hypertension
• Already receiving rehabilitation
• History of trauma or fracture
• Any related orthopedic conditions
• CVS related conditions
• Autonomic neuropathy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Feldenkrais Exercises; Participants perform Feldenkrais exercises for 40 minutes per session, focusing on somatosensory re-education, axial movements, and balance.	Other: Feldenkrais Exercises; This intervention includes 16 specific movement lessons (e.g., turning improvement, weight transference, sensing the feet, walking in tandem). The protocol is derived from Mazuelas et al. 2024. Sessions are 40 minutes, twice a week for 12 weeks, guided by a physiotherapist.; Other: baseline warm up and cool down Exercises; Warm up exercises: Warm up exercises before the start of training exercises for about ten minutes. These include: • Leg swings (forward and backward) • Side to side leg swings • Leg kicks 20 reps/side • Standing on tip toes • Mild stretching Cool down exercises: Cool Down exercises after the end of training exercises for about ten minutes to induce relaxation. These include: • Deep breathing exercise • Abdominal breathing exercise • Leg swings • Standing on tip toes • Mild stretching
Active Comparator: Task Oriented Gait Training; Participants perform Task Oriented Gait Training for 45 minutes per session, focusing on functional tasks like walking on surfaces, changing directions, and obstacle negotiation.	Other: baseline warm up and cool down Exercises; Warm up exercises: Warm up exercises before the start of training exercises for about ten minutes. These include: • Leg swings (forward and backward) • Side to side leg swings • Leg kicks 20 reps/side • Standing on tip toes • Mild stretching Cool down exercises: Cool Down exercises after the end of training exercises for about ten minutes to induce relaxation. These include: • Deep breathing exercise • Abdominal breathing exercise • Leg swings • Standing on tip toes • Mild stretching; Other: Task Oriented Gait Training; This intervention includes functional tasks such as walking with reduced base of support, obstacle crossing, and ramp walking. The protocol is derived from Salsabili et al. 2015. Sessions are 45 minutes, twice a week for 12 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Berg Balance Scale Score	The Berg Balance Scale (BBS) measures static and dynamic balance. It contains 14 items scored from 0 to 4. Total score ranges from 0 to 56. Higher scores indicate better balance.	Baseline, Week 6, Week 12
Change in Ankle Joint Proprioception	Measured using the Joint Position Sense Test (JPST) with a goniometer. The participant actively reproduces a target joint angle. The difference in degrees between the target and the reproduction is recorded. Smaller differences indicate better proprioception.	Baseline, Week 6, Week 12
Change in Tactile Sensation	Measured using the Semmes-Weinstein Monofilament (10g). The filament is applied to 10 sites on the plantar surface of the foot. The number of correctly detected applications out of 10 is recorded. Higher scores indicate better sensation.	Baseline, Week 6, Week 12

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Cumulative Somatosensory Impairment Index (CSII)	Measures somatosensory postural control and functional awareness. Scale range and specific scoring will be calculated per the CSII manual.	Baseline, Week 6, Week 12
Change in Fear of Falling	Measured using the Fall Efficacy Scale (FES). Participants rate confidence in performing 10 activities without falling. Scores range from 10 (high confidence) to 100 (low confidence).	Baseline, Week 6, Week 12
Change in Quality of Life	Measured using the SF-36 Questionnaire. This tool assesses physical and mental health across 8 domains. Scores are transformed into a scale from 0 to 100. Higher scores indicate better quality of life.	Baseline, Week 6, Week 12
Self-Awareness Learning Adherence	Measured by the return of a structured educational brochure checklist. Participants report if they performed prescribed home self-learning activities.	Week 12

Collaborators and Investigators

• Sponsor: University of Faisalabad

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2026
• Primary Completion (Actual): April 1, 2026
• Study Completion (Estimated): May 28, 2026

Study Registration Dates

• First Submitted: May 23, 2026
• First Submitted That Met QC Criteria: May 23, 2026
• First Posted (Actual): June 1, 2026

Study Record Updates

• Last Update Posted (Actual): June 1, 2026
• Last Update Submitted That Met QC Criteria: May 23, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Balance; Neuropathy; Proprioception; Feldenkrais; Task Oriented Gait Training
• Additional Relevant MeSH Terms: Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Therapeutics; Physical Therapy Modalities; Rehabilitation; Exercise; Post-Exercise Recovery Techniques; Cool-Down Exercise
• Other Study ID Numbers: TUF/EIRB/ 221 /26

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No