Effectiveness of the Fall-Proof Rehabilitation Exercise Software on LightTouch and Vibration Sensory Function in Patients with Diabetic Polyneuropathy

Abstract

Objective Diabetic polyneuropathy (DPN) is one of the most common complications of type 2 diabetes, characterized by diminished light touch and vibration perception, leading to impaired balance and increased fall risk among older adults. Despite its high prevalence, evidence on targeted sensory rehabilitation remains limited. This study aimed to evaluate the effectiveness of a Fall-Proof rehabilitation exercise software in improving sensory function in elderly patients with DPN. Materials & Methods This study was a single-blind clinical trial conducted in 2025 at Sadeghieh Tahereh Hospital in Isfahan. A total of 96 patients diagnosed with diabetic peripheral neuropathy, confirmed using the michigan neuropathy screening instrument (MNSI), were randomly assigned via adaptive randomization into three groups: An in-person intervention group, a virtual intervention group (utilizing a dedicated software platform), and a control group. The intervention groups performed FallProof (TM) balance exercises for eight weeks (two sessions per week), either in person or virtually, whereas the control group received only standard care. Sensory function- including light touch sensation at the third and fifth metatarsal heads and the hallux, as well as vibratory sensation at the hallux-was assessed at four time points: pre-intervention, immediately post-intervention, and at 2-and 3-month follow-ups. Data were analyzed using non-parametric statistical tests, including the Friedman test, Wilcoxon signed-rank test, and Mann-Whitney U test, with significance set at P<0.05. Results Both intervention groups showed significant improvements in all sensory indices (P<0.05), with the greatest gains observed at the 5(th) metatarsal and hallux. Compared with controls, the digital intervention group demonstrated superior improvements in light touch at the 5th metatarsal (+1.80 units), hallux (+1.22 units), and vibration perception (+0.36 units). Importantly, these sensory improvements persisted for up to 3 months in the digital group, whereas the control group experienced progressive decline. Conclusion Fall-proof exercises, particularly when delivered through interactive rehabilitation software, produced significant, targeted, and sustained improvements in tactile and vibration perception in elderly patients with DPN. These findings underscore the potential of digital-based interventions in sensory rehabilitation and fall prevention, supporting their integration into home-based rehabilitation programs for high-risk populations.