Effects Of Otago Exercise Versus Multisensory Integration Training On Balance And Gait In Elderly With Diabetes (Balance - DM)

August 17, 2026 updated by: Toka Adel Mohammed Fahmy, Cairo University

The goal of this clinical trial is to compare the effect of the Otago exercise and Multisensory integration training on balance and gait in the elderly with type 2 diabetes mellitus.

The main question it aims to answer is:

• Is there a significant difference between the effect of Otago exercise and Multisensory integration training on balance and gait in the elderly with type 2 diabetes mellitus? Researchers will compare Otago exercise to Multisensory integration training to know which one has the greatest benefit on balance &gait in the elderly with type2 diabetes.

Participants will be divided into 3 groups; each group takes a certain training program for 8 weeks:

  • First group: Otago exercise group plus conventional treatment for neuropathy.
  • Second group: Multisensory integration training group plus conventional treatment for neuropathy.
  • Third group: control group takes only conventional treatment for neuropathy.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Diabetes one of the most prevalent chronic non-communicable diseases. Diabetic peripheral neuropathy (DPN) is a prevalent complication of diabetes, affecting about 50% of diabetic patients.

DPN characterized by peripheral nerve dysfunction. It initially presents sensory symptoms like numbness and tingling, which may evolve into pain and heightened sensitivity. Subsequently, motor symptoms such as muscle weakness and coordination difficulties appear, potentially leading to muscle atrophy.

Due to all these changes affecting peripheral nerve function, the functions of the lower extremities will be disturbed, which facilitate normal posture and walking, resulting in a loss of somatosensation and proprioception. This decreased sensitivity in the feet leads to balance defects, particularly in elderly and diabetic individuals.

The Otago exercise program is effective in preventing falls in older adults by improving cognitive function, balance, strength, functional fitness, and recovery, while reducing costs. Furthermore, multisensory exercises enhance balance and mobility by targeting sensory systems, thus lowering fall risk compared to traditional methods focused on physical strength or motor skills.

Both interventions positively affect balance and mobility in older adults with type 2 diabetes, but direct comparisons of their effectiveness are limited. This study aims to fill that gap by evaluating two rehabilitation interventions, potentially aiding clinical decision-making by identifying the more effective option for enhancing postural stability and mobility.

Study Type

Interventional

Enrollment (Estimated)

90

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Toka Adel Mohammed Fahmy, physiotherapist
  • Phone Number: +201064030561
  • Email: pttokaadel@gmail.com

Study Locations

  • Egypt
      • Zagazig, Egypt
        • El-Qenayat Central Hospital
        • Contact:

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

  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Ninety elderly Patients of both genders.
  2. Their age will range from 65 to 75th.
  3. They will be diagnosed with type 2 diabetes for 5 years or more.
  4. Patients with mild & moderate neuropathy will be included. (Based on the Toronto scale: -mild (6-8); moderate (9-11)
  5. Berg balance between (21 to <50) patients with mild &moderate risk of fall .
  6. Time up & go dual task: patient takes longer than 10 sec.
  7. HBA1C for these patients was ≥ 6.5% .
  8. BMI will range from (18: 29,9 kg/m2).
  9. Able to walk independently, with or without assistive devices.

Exclusion Criteria:

  1. Any musculoskeletal disorder affecting the lower limb (fracture of the lower limb, tumors, any infection, ligament injuries, foot injuries).
  2. Any other neurological disorder influences gait such as (stroke, Parkinson's disease, cerebellar dysfunction, ataxia, vestibular disorders)
  3. Any other cardiovascular disease (arrhythmia, cardiac pacemakers).
  4. Unstable proliferative retinopathy and visual impairments without correction.
  5. Non-diabetic neuropathy (inflammatory, autoimmune disease, infections, tumors, vitamin B12 deficiency, hypothyroidism, alcoholism, injury or pressure on the nerve).
  6. The use of medications significantly impacting postural control (e.g., sedatives).
  7. Vestibular system and Cognitive disorders.
  8. Uncontrolled hypertension.
  9. Common peroneal nerve injury.
  10. Orthostatic hypotension.

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
Active Comparator: Otago exercise group
Otago exercise plus conventional treatment for neuropathy. for 3d/w for 8weeks.
Other: Otago exercise

Exercise program consisted of ( flexibilty - strengthening - balance ) exercise for elderly.

Time of each session (50:60 min). For 3d/w for 8weeks.

Other: conventional treatment for neuropathy
conventional treatment for improving balance and gait problem associated with DPN For 3d/w for 8weeks
Active Comparator: Multisensory integration training group

Multisensory integration training group with conventional treatment for neuropathy.

for 3d/w for 8 weeks.
Other: conventional treatment for neuropathy
conventional treatment for improving balance and gait problem associated with DPN For 3d/w for 8weeks
Other: Multisensory integration training
Multisensory integration training is a group of balance exercise depend on facilitating different sensory systems (visual-vestibular-propioception) Time for each session (50 min). For 3d/w for 8weeks.
Active Comparator: control group
Only conventional treatment for neuropathy For 3d/w for 8 weeks.
Other: conventional treatment for neuropathy
conventional treatment for improving balance and gait problem associated with DPN For 3d/w for 8weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Balance: ( Time up & go test )dual task
Time Frame: From enrollment to the end of treatment at 8 weeks
From enrollment to the end of treatment at 8 weeks
Balance: Berg Balance Scale
Time Frame: From enrollment to the end of the treatment at 8 weeks
From enrollment to the end of the treatment at 8 weeks
Gait speed (10m walk test)
Time Frame: From enrollment to the end of the treatment at 8 weeks
From enrollment to the end of the treatment at 8 weeks

Secondary Outcome Measures

Outcome Measure
Time Frame
Functional reach test.
Time Frame: From enrollment to the end of treatment at 8 weeks
From enrollment to the end of treatment at 8 weeks
Modified fall efficacy scale
Time Frame: From enrollment to the end of treatment at 8 weeks
From enrollment to the end of treatment at 8 weeks
Toronto clinical neuropathy score
Time Frame: From enrollment to the end of treatment at 8 weeks
From enrollment to the end of treatment at 8 weeks

Collaborators and Investigators

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

Sponsor

Cairo University

Investigators

  • Principal Investigator: Gehad Ali Abd-Elhasseb, Assistant Professor, Cairo University
  • Principal Investigator: Fatma Younis Mahmoud Abd-Elsalam, Lecturer of Physical Therapy, Cairo University
  • Principal Investigator: Eman Mohamed El-Sayed Deif, consultant internal medicine

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)

October 1, 2026

Primary Completion (Estimated)

October 1, 2027

Study Completion (Estimated)

November 1, 2027

Study Registration Dates

First Submitted

August 9, 2026

First Submitted That Met QC Criteria

August 17, 2026

First Posted (Actual)

August 20, 2026

Study Record Updates

Last Update Posted (Actual)

August 20, 2026

Last Update Submitted That Met QC Criteria

August 17, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • balance exercise for elderly

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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