Adaptive Gamified Sensory Training on Sensory Function and Limb-Specific Functional Performance in Patients With Diabetic Peripheral Neuropathy

Effects of Adaptive Gamified Sensory Training on Sensory Function and Limb-Specific Functional Performance in Patients With Diabetic Peripheral Neuropathy: A Randomized Controlled Trial

Diabetic peripheral neuropathy (DPN) will be considered a clinically important complication of diabetes mellitus that may impair sensory function and interfere with the performance of daily activities involving the hands and feet. Sensory deficits may affect tactile perception, object manipulation, foot-related functional tasks, and the ability to interact safely with the surrounding environment.

The purpose of this study will be to investigate the effects of adaptive gamified sensory training combined with conventional physical therapy on sensory function, sensory integration during balance, and hand functional performance in patients with diabetic peripheral neuropathy.

Study Overview

• Status: Not yet recruiting
• Conditions: Diabetic Peripheral Neuropathy
• Intervention / Treatment: Other: Adaptive Gamified Sensory Training; Other: Conventional Physical Therapy Group

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

Contacts and Locations

• Study Contact: Name: hanan mohamed; Phone Number: +962775661825; Email: h.hosny@zuj.edu.jo

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 45 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• age from 45 to 65 years old
• both Sex
• Have a documented diagnosis of diabetes mellitus for more than five years.
• Have clinically confirmed diabetic peripheral neuropathy affecting both the upper and lower limbs.
• Are medically stable and able to participate in the proposed rehabilitation program.
• Are able to understand the instructions and complete the required sensory and functional assessments.
• Provide written informed consent.

Exclusion Criteria

• Active foot ulcers, open wounds, or skin lesions that will make sensory testing or training unsafe.
• An acute foot infection or another condition requiring urgent medical management.
• Severe cognitive or visual impairment that will prevent safe participation in the proposed tasks.
• Another neurological or musculoskeletal condition that will substantially interfere with sensory assessment or the planned functional tasks.
• A medical condition that will make participation in the rehabilitation program unsafe.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Adaptive Gamified Sensory Training Group; The therapist will additionally record tactile discrimination accuracy, selected games, application settings, and progression between task levels.	Other: Adaptive Gamified Sensory Training; Participants will receive a 6-week intervention consisting of three sessions per week (18 sessions total), with each session lasting 90 minutes. The intervention will include 30 minutes of conventional physical therapy, 30 minutes of upper-limb sensory training involving tactile sensory discrimination and interactive gamified hand exercises using a Bluetooth-connected ball, and 30 minutes of lower-limb sensory training involving progressive, task-oriented activities using visual targets, safe textured surfaces, texture matching, and controlled foot placement and weight shifting. Task difficulty will be progressively adjusted according to participants' performance and tolerance. Device and tools: Bluetooth-connected interactive squeeze ball Foam balance pad Textured sensory stimulation materials Visual floor targets
Active Comparator: Conventional Physical Therapy Group; upper-limb conventional exercises Lower-limb strengthening: Conventional balance exercises: Gait and functional mobility training:	Other: Conventional Physical Therapy Group; Participants will receive a 6-week conventional rehabilitation program consisting of three sessions per week (18 sessions total), with each session lasting 90 minutes. The program will include 30 minutes of shared conventional physical therapy, 15 minutes of upper-limb range-of-motion and functional exercises, 15 minutes of lower-limb strengthening exercises, 15 minutes of balance training, and 15 minutes of gait and functional mobility training. Exercises will be adapted to participants' functional abilities and safety requirements. devices and tools: Foam balance pad Textured sensory stimulation materials Visual floor targets

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neuropathy Impairment Scale (NIS) - Sensory Subset	Change in sensory function from baseline to 6 weeks, assessed using the sensory subset of the Neuropathy Impairment Scale (NIS). Assessment includes touch pressure, pinprick, vibration, and joint position at the right and left index fingers and great toes. Higher scores indicate greater sensory impairment. Grading: NIS Sensory Subset; 0 = Normal sensation; 1 = Decreased sensation; 2 = Absent sensation Scale title: Neuropathy Impairment Scale - Sensory Subset (NIS Sensory Subset). Minimum value: 0 Maximum value: 32* Interpretation: Higher scores indicate worse sensory impairment; lower scores indicate better sensory function.	6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Jebsen-Taylor Hand Function Test (JTHFT)	Change in hand functional performance from baseline to post-intervention at 6 weeks, assessed using the Jebsen-Taylor Hand Function Test. Grading: Performance time in seconds for each subtest. Shorter completion times indicate better hand function.; Unabbreviated scale title: Jebsen-Taylor Hand Function Test.; Minimum value: 0 seconds (theoretical minimum).; Maximum value: No fixed maximum; the score is recorded as the time required to complete each task.; Interpretation: Higher scores (longer completion times) indicate worse hand function, whereas lower scores (shorter completion times) indicate better hand function. Important: The JTHFT consists of seven timed subtests. Report the completion time in seconds for each subtest rather than treating it as a conventional 0-100 scale.	6 weeks
Biodex Balance System-Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), if this is the specific test selected for your protocol. Device Biodex Balance System	Condition 1: Eyes Open on a Firm Surface The participant stands on a firm, stable surface with eyes open. Visual, somatosensory, and vestibular information are available. Condition 2: Eyes Closed on a Firm Surface The participant stands on a firm, stable surface with eyes closed. Visual input is removed, increasing reliance on somatosensory and vestibular information. Condition 3: Eyes Open on a Foam Surface The participant stands on a foam surface with eyes open. The foam reduces the reliability of somatosensory information from the feet and ankles. Condition 4: Eyes Closed on a Foam Surface The participant stands on a foam surface with eyes closed. Both visual input and reliable somatosensory information are reduced, increasing reliance on vestibular information. Lower sway values generally indicate less postural sway and better postural stability. Higher sway values: generally indicate greater postural sway and poorer postural stability.	6 weeks

Collaborators and Investigators

• Sponsor: Al-Zaytoonah University of Jordan

Study record dates

Study Major Dates

• Study Start (Estimated): November 15, 2026
• Primary Completion (Estimated): December 15, 2026
• Study Completion (Estimated): December 25, 2026

Study Registration Dates

• First Submitted: October 25, 2026
• First Submitted That Met QC Criteria: October 25, 2026
• First Posted (Actual): October 30, 2026

Study Record Updates

• Last Update Posted (Actual): November 4, 2026
• Last Update Submitted That Met QC Criteria: November 1, 2026
• Last Verified: November 1, 2026

More Information

Terms related to this study

• Keywords: diabetic peripheral neuropathy; sensory function; NIS Sensory Subset; Gamified Sensory Training
• Other Study ID Numbers: Diabetic peripheral neuropathy

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