Effects of hydrotherapy with massage on serum nerve growth factor concentrations and balance in middle aged diabetic neuropathy patients

Background: and purpose: Nerve growth factor (NGF) concentrations and balance are reduced in diabetic neuropathy (DN) patients. We examined the effects of hydrotherapy and massage on NGF, balance and glycemic markers in middle aged DN patients. Materials and methods: Patients were randomly assigned into four groups, aquatic exercise (AE; n = 10), AE + massage (AM; n = 10), massage (M; n = 10) or control (C; n = 9). Subjects in AE and AM groups exercised three times per week. Subjects in the AM and M groups received massage during the same period. Glycemic markers, NGF and balance were evaluated prior to and following the interventions. Results: NGF, glycemic markers and dynamic balance improved in AE, AM and M groups; however, the increase was greater following the AM trial (p < 0.01) when compared to the other trials. Conclusion: A combination of hydrotherapy and massage enhances NGF concentrations, balance and the glycemic profile compared to hydrotherapy or massage alone.