Comparison of Active vs Passive Neural Mobilizations Effects in Improving Burning Pain, Muscular Strength, and Range of Motion in Patients With Diabetic Neuropathy

Summary

* Randomized controlled trial evaluating active and passive neurodynamic techniques for diabetic neuropathy.
* Sample size: 60 patients (30 per group), aged 40 to 65 years, diagnosed with diabetes mellitus.
* Exclusion criteria: Systemic diseases, pregnancy, fractures, foot ulceration, amputation, osteoarthritis.
* Study will be conducted at physiotherapy OPDs of Dow Ojha Hospital, DIPMR,NIDE and Baqai Institute of Diabetology and Endocrinology.
* Participants randomly assigned into two groups using a computer-generated randomization sheet.

Group A: Active neurodynamics (neural flossing) - patient-controlled nerve gliding movements.

Group B: Passive neurodynamics (tensioners) - therapist-applied nerve stretches.

* Standard treatment includes gait training, lower limb strengthening exercised, and stationary bike sessions.
* Treatment: 12 sessions over 4 weeks (3 sessions per week, 30 minutes each session).
* Assessments will be done at baseline and post-intervention by a blinded physical therapist.
* Outcome measures: DN-4 (pain), MMT (muscle strength), Goniometry (ROM), LLTT (nerve mobility).
* Data were analyzed using SPSS Version 27. A one-way ANOVA was performed to compare the results before and after the intervention.
* Study duration: 9 months, including approval, pilot study, data collection, and final presentation.
* Study aims to determine the most effective neurodynamic technique for pain relief, mobility, and muscle strength.
* Findings will guide better rehabilitation strategies for improved patient outcomes and quality of life.

Conditions

• Neuropathy
• Diabete Mellitus
• Diabetic Neuropathy

Interventions

OTHER

Active Neural Mobilzations

Participants in this group will receive active neural mobilization in the form of neural flossing techniques. These involve controlled, repeated movements performed actively by the patient to mobilize peripheral nerves without placing them under excessive tension. The goal is to restore neural mobility, reduce mechanosensitivity, and relieve neuropathic symptoms such as burning pain.

OTHER

Passive Neural Mobilzations

Participants in this group will receive passive neural mobilization using neural tensioning techniques. These techniques involve therapist-applied passive limb movements that place a controlled tensile load on the neural structures. The objective is to improve neural gliding, reduce nerve compression, and decrease neuropathic pain, particularly in cases of restricted neural tissue mobility.

Sponsors & Collaborators

• Baqai Institute of Diabetology and Endocrinology

  collaborator OTHER

• Dow University of Health Sciences

  lead OTHER

Principal Investigators

• Farhan Ishaque Khan, PhD · Dow Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

40 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-06-04

Primary Completion

2025-08-23

Completion

2025-09-01

Countries

• Pakistan

Study Locations