Effect of Retro Walking Combined with Lagos Neuropathy Protocol on Balance and Spatiotemporal Parameters of Gait among Patients with Diabetic Neuropathy: A Prospective Interventional Study

Introduction: Diabetic Peripheral Neuropathy (DPN) clinically manifests as a sensorimotor disturbance that leads to complications in gait alteration and balance impairment. Balance and locomotion are the most critical aspects of an individual's independence. Aim: To assess the effect of Retro walking with Lagos Neuropathy Protocol (LNP) on balance and spatiotemporal parameters of gait among patients with Diabetic neuropathy. Materials and Methods: The present prospective interventional Study was conducted in the Outpatient Department (OPD), Krupanidhi College of Physiotherapy, Bengaluru, Karnataka, India, from October 2022 to June 2023. The sample size was 60 individuals, 30 in each group (experimental and control group). Group 1, the control group, received the conventional LNP. Group 2, the experimental group, received the LNP combined with backward walking. The interventions were given to the patients four times/week for eight weeks. Subjects were assessed at the initial stage and following the end of the intervention. The parameters assessed were balance and spatiotemporal parameters of gait, in which balance was assessed by using the Mini Balance Evaluation Systems Test (Mini-BESTest) and gait speed using a 10 m walk test; other gait parameters cadence, step length, and stride length were measured individually using a stopwatch and inch tape. The statistical software used was Statistical Package for the Social Sciences (SPSS) software version 29.0, and the tests included were paired t-tests and independent t-tests for data analysis. Result: The mean +/- Standard Deviation (SD) age of the experimental group participants was 51 +/- 3.24 years, and the control group was 50.87 +/- 3.12 years. A significant improvement was seen in cadence, step length, stride length, gait speed, and balance in the control and experimental group (p-value<0.001) Greater improvement was found in the experimental group when compared with the control group in all the outcome measures. Significant improvement was seen in all parameters in the experimental group when compared to the control group at post-test (p-value <0.05). Conclusion: The study concluded that the LNP combined with backward walking had a significant positive effect on balance and spatiotemporal determinants of gait than the LNP alone among DPN patients.