Effects of Virtual Yoga on Functional Balance and Limits of Stability in Adults with Diabetic Peripheral Neuropathy: A Randomised Controlled Trial

Abstract

Introduction: Diabetic Peripheral Neuropathy (DPN) is a prevalent consequence of Type 2 Diabetes Mellitus (T2DM) that severely impacts balance, postural control, and functional mobility. Virtual yoga has been proposed as a potential rehabilitation approach that anybody can use, although there is not much information addressing how it affects measurable outcomes related to balance in patients with DPN. Aim: To determine the effects of an eight-week virtual yoga program on functional balance and Limits Of Stability (LOS) in middle-aged persons with DPN. Materials and Methods: A single-blinded randomised controlled study was conducted among 50 adults aged 40-59 years with DPN. Participants were randomised into the virtual yoga group (n=25) or conventional physiotherapy group (n=25). Both groups received supervised interventions for eight weeks, three times per week. Outcome measurements comprising Single Leg Stand Test (SLST), Four Square Step Test (FSST) and LOS parameters included Reaction Time (RT) and Directional Control (DCL). Baseline and post-intervention assessments were conducted. For intragroup comparisons, either the Paired T-Test (PTT) or the Wilcoxon Signed Rank Test (WSRT) was employed and for intergroup comparisons either the Independent samples t-test (ITT) or the Mann-Whitney U Test (MWUT) was utilised, depending on the distribution of the outcome variable. Results: Significant intragroup improvements were observed after intervention in both groups (p <0.05). However, the virtual yoga group revealed significant improvement in SLST, FSST, LOS RT, and DCL in most directions (p<0.05) with moderate-tolarge effect sizes compared with the conventional physiotherapy group. Conclusion: An eight-week virtual yoga program significantly improved functional balance and LOS in middle-aged persons with DPN. Virtual yoga may be a useful supplemental homebased rehabilitation technique to improve balance and stability in this group.