Efficacy of a Structured Multisensory Re-education Program on Sensory Function and Upper Limb Sensorimotor Performance in Individuals With Diabetic Peripheral Neuropathy. (SENS-UL)

June 25, 2026 updated by: Turki Abualait, Imam Abdulrahman Al Faisal Hospital

Efficacy of a Structured Multisensory Re-education Program on Sensory Function and Upper Limb Sensorimotor Performance in Individuals With Diabetic Peripheral Neuropathy: A Randomized Sham-Controlled Trial.

Diabetic Peripheral Neuropathy (DPN) is a common complication of diabetes that can cause impairments in sensation, dexterity, and upper-limb function. Current treatment approaches mainly focus on symptom management and glycemic control, while interventions specifically targeting sensory recovery remain limited.

This randomized sham-controlled trial aims to evaluate the effectiveness of a Structured Multisensory Re-education Program (SENS-UL) in improving sensory function and upper-limb sensorimotor performance in adults with DPN. Participants will be randomly assigned to either an intervention group receiving structured multisensory sensory re-education or a sham-control group receiving passive sensory exposure without active sensory retraining.

The intervention will be delivered twice weekly for five weeks. Outcome measures will include sensory function, neuropathy severity, thermal and tactile sensation, vibration perception, proprioception, dexterity, and neuropathy-related quality of life. Assessments will be conducted before and after the intervention period.

The study is expected to provide evidence regarding the effectiveness of multisensory sensory rehabilitation for individuals with DPN and may contribute to the development of targeted rehabilitation strategies aimed at improving sensory recovery, hand function, and quality of life.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Diabetic Peripheral Neuropathy (DPN) is one of the most common chronic complications of diabetes mellitus and is associated with sensory loss, impaired sensorimotor performance, reduced functional independence, and decreased quality of life. Although DPN is commonly associated with lower-limb dysfunction, upper-limb sensory impairments may also occur and negatively affect hand function, dexterity, object manipulation, and activities of daily living.

Current management strategies primarily focus on glycemic control, pharmacological symptom management, and general exercise interventions. However, rehabilitation approaches specifically designed to improve sensory function remain limited. Evidence from neurorehabilitation research suggests that sensory re-education interventions may promote neuroplasticity, improve sensory discrimination, enhance cortical sensory processing, and improve functional outcomes.

This study will investigate the efficacy of a Structured Multisensory Re-education Program (SENS-UL Protocol) in adults with clinically confirmed Diabetic Peripheral Neuropathy. The study will use a prospective, parallel-group, participant-blinded, randomized sham-controlled design.

Participants will be recruited from King Fahad Medical City, Riyadh, Saudi Arabia. Eligible participants will be randomly allocated to either an experimental group receiving structured multisensory sensory re-education or a sham-control group receiving passive sensory exposure without active sensory retraining. The intervention will be delivered twice weekly for five weeks, with each session lasting approximately 50-60 minutes.

The intervention includes tactile stimulation, texture discrimination, vibration stimulation, thermal discrimination, localization training, joint position sense training, kinesthesia training, two-point discrimination, stereognosis, barognosis, graphesthesia, and double simultaneous stimulation. The program follows a standardized hierarchical progression model with predefined progression criteria.

Primary outcomes include sensory function performance, Modified Total Neuropathy Score (mTNS), thermal sensory thresholds, Semmes-Weinstein Monofilament Test, vibration perception threshold, joint position sense, two-point discrimination, and neuropathy-related quality of life. Secondary outcomes include Nine-Hole Peg Test and Grooved Pegboard Test performance.

The findings of this study are expected to provide evidence regarding the role of multisensory sensory rehabilitation in improving sensory recovery and upper-limb function in individuals with Diabetic Peripheral Neuropathy.

Study Type

Interventional

Enrollment (Estimated)

59

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

InclusioInclusion Criteria:

Adults aged 18 to 75 years. Clinically confirmed diabetic peripheral neuropathy (DPN). Stable medical condition and medication regimen for at least 3 months. Ability to understand study procedures and provide informed consent. Ability to participate in upper-limb sensory and sensorimotor assessments. Willingness to attend all intervention sessions and follow study instructions.

Exclusion Criteria:

Other neurological disorders affecting sensory or motor function (e.g., stroke, multiple sclerosis, Parkinson's disease).

Severe visual, auditory, or cognitive impairment interfering with participation.

Upper-limb musculoskeletal conditions limiting hand function or assessment performance.

Active foot ulcer, severe diabetic complications, or unstable medical condition.

Participation in another rehabilitation or clinical trial during the study period.

Pregnancy.

Inability to comply with study procedures or follow-up assessments.n Criteria:

Exclusion Criteria:

-

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Multisensory Re-education Group
Participants will receive a structured multisensory re-education program targeting sensory deficits associated with diabetic peripheral neuropathy. The intervention will be delivered twice weekly for five weeks and will include tactile, thermal, vibration, proprioceptive, and sensory discrimination training.
Behavioral: Structured Multisensory Re-education Program
A structured multisensory re-education program targeting sensory deficits in individuals with diabetic peripheral neuropathy. The program includes tactile, thermal, vibration, proprioceptive, and sensory discrimination training delivered twice weekly for five weeks.
Sham Comparator: Sham Control Group
Participants will receive sham sensory exposure sessions without active sensory retraining. The frequency and duration of sessions will match the experimental group.
Behavioral: Behavioral: Sham Sensory Exposure
Participants in the sham control group will receive passive sensory exposure sessions without structured sensory re-education, active sensory discrimination training, feedback, or progression of sensory tasks. The duration and frequency of sessions will be matched to the experimental group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Composite Sensory Function Score Measured Using Quantitative Sensory Testing (QST)
Time Frame: Baseline and Post-intervention (5 Weeks)
Composite sensory function will be assessed using Quantitative Sensory Testing (QST) comprising the Semmes-Weinstein Monofilament Test (SWMT; monofilament level), Vibration Perception Threshold (VPT; Hz), Cold Detection Threshold (°C), Warm Detection Threshold (°C), Joint Position Sense (degrees of reposition error), and Two-Point Discrimination (mm). A standardized composite sensory function score will be calculated from these measures. Higher composite scores indicate better sensory function.
Baseline and Post-intervention (5 Weeks)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Neuropathy Severity Measured by the Modified Total Neuropathy Score (mTNS)
Time Frame: Baseline and Post-intervention (5 Weeks)
Neuropathy severity will be assessed using the Modified Total Neuropathy Score (mTNS). The mTNS evaluates sensory symptoms, motor symptoms, pin sensibility, vibration sensibility, muscle strength, and deep tendon reflexes. The outcome measure will be the total mTNS score (points; range 0-24), with lower scores indicating less severe neuropathy.
Baseline and Post-intervention (5 Weeks)
Upper Limb Dexterity Measured by the Nine-Hole Peg Test (9HPT)
Time Frame: Baseline and Post-intervention (5 Weeks)
Upper limb dexterity will be assessed using the Nine-Hole Peg Test (9HPT). The outcome measure will be completion time (seconds). Lower times indicate better hand dexterity.and fine motor performance.
Baseline and Post-intervention (5 Weeks)
Manual Dexterity Measured by the Grooved Pegboard Test (GPT)
Time Frame: Baseline and Post-intervention (5 Weeks)
Manual dexterity and sensorimotor coordination will be assessed using the Grooved Pegboard Test (GPT). The outcome measure will be completion time (seconds). Lower times indicate better manual dexterity and sensorimotor coordination.
Baseline and Post-intervention (5 Weeks)
Neuropathy-Related Quality of Life Measured by Neuropathy-Specific Quality of Life Questionnaire
Time Frame: Baseline and Post-intervention (5 Weeks)
Neuropathy-related quality of life will be assessed using the Neuropathy-related Quality of Life Questionnaire. The outcome measure will be the total questionnaire score (points) according to the instrument scoring manual.
Baseline and Post-intervention (5 Weeks)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Imam Abdulrahman Al Faisal Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

July 31, 2028

Study Completion (Estimated)

September 30, 2028

Study Registration Dates

First Submitted

June 21, 2026

First Submitted That Met QC Criteria

June 25, 2026

First Posted (Actual)

June 26, 2026

Study Record Updates

Last Update Posted (Actual)

June 26, 2026

Last Update Submitted That Met QC Criteria

June 25, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • SENS-UL-DPN-RCT-2026

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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