Effects of Neuromuscular Electrical Stimulation Combined with Exercise Therapy in Diabetic Neuropathy

Background: Diabetic peripheral neuropathy is a complication of diabetes causing pain, sensory loss, muscle weakness, balance deficits, and reduced mobility, leading to decreased independence and increased fall risk. Objective: To evaluate the effects of neuromuscular electrical stimulation combined with exercise on neuropathy severity, pain, balance, mobility, strength, sensory function, and quality of life in individuals with diabetic peripheral neuropathy. Methodology: A randomized controlled trial was conducted involving 65 participants with diabetic peripheral neuropathy. Participants were randomly allocated to an experimental group receiving neuromuscular electrical stimulation combined with a structured exercise program or a control group receiving exercise therapy alone. Neuropathy severity was assessed using the Michigan Neuropathy Screening Instrument. Pain intensity was measured using the Numeric Pain Rating Scale, functional balance using the Berg Balance Scale, and mobility using the Timed Up and Go test. Lower-limb strength and functional endurance were measured using the Five Times Sit-to-Stand Test. Sensory function was evaluated using Semmes-Weinstein monofilament testing. Quality of life was assessed using the NeuroQoL questionnaire. Baseline comparisons between groups were performed using independent sample t-tests for continuous variables and chi-square tests for categorical variables. Within-group changes from pre- to post-intervention were analyzed using paired sample t-tests. Between-group post-intervention differences were assessed using independent sample t-tests. Effect sizes were calculated using Cohen’s d. Results: Both groups showed significant improvements in all outcome measures following treatment (p