Effects of a Structured Education and Exercise Program on Spatiotemporal Gait Parameters and Plantar Pressure in Individuals with Diabetic Peripheral Neuropathy: A Randomized Controlled Trial.

Abstract

To investigate the effects of a structured and supervised education and exercise program on spatiotemporal gait parameters and plantar pressure distribution in individuals with diabetic peripheral neuropathy (DPN). Randomized controlled trial. Spatiotemporal gait parameters were assessed using a wireless inertial sensor system (BTS G-Sensor®), and plantar pressure distribution was evaluated through static and dynamic pedobarographic analysis (RSscan®) before and after an 8-week intervention (ClinicalTrials.gov Identifier: NCT05431660). Clinical gait analysis laboratory in a tertiary care facility. Twenty-four individuals with DPN were randomly assigned to a treatment group (n=12) or a control group (n=12). The treatment group received an 8-week structured and supervised education and exercise program including foot-ankle biomechanics, strengthening, and gait training. The control group received an 8-week standardized diabetic foot education program without supervised exercise. Gait speed was the primary outcome. Secondary outcomes included additional spatiotemporal gait parameters and plantar pressure distribution variables. The treatment group demonstrated significant improvements in gait speed, cadence, and gait cycle duration (p < 0.05). Static and dynamic pedobarographic analyses revealed reduced forefoot and toe loading and increased rearfoot loading in the treatment group, whereas the control group showed increased pressure beneath the second and third metatarsal heads. An 8-week structured and supervised education plus exercise program significantly improved gait performance and promoted a more physiological plantar load redistribution in individuals with DPN. These findings support the integration of supervised exercise into multidisciplinary diabetic foot care programs, with potential implications for reducing ulcer risk and enhancing functional mobility.