EFFECTIVENESS OF A STRUCTURED PHYSIOTHERAPY PROGRAM ON BALANCE, FALL RISK, AND GLYCEMIC CONTROL IN ADULTS WITH TYPE 2 DIABETES MELLITUS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Type 2 diabetes mellitus (T2DM) is associated with impaired balance, reduced functional mobility, increased susceptibility to falls, and disturbances in glycemic control. Structured physiotherapy may help address these complications; however, its additional benefits over usual diabetes care require further evaluation. Objective: To determine the effectiveness of a structured physiotherapy program on balance, functional mobility as an indicator of fall risk, and glycemic control in adults with T2DM. Methods: A two-arm, parallel-group randomized controlled trial included 64 adults with T2DM, allocated equally to an experimental group (n = 32) receiving structured physiotherapy in addition to usual diabetes care and a control group (n = 32) receiving usual diabetes care alone. Outcomes were assessed at baseline and after 12 weeks using the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and glycated hemoglobin (HbA1c). Baseline adjusted between-group comparisons were reported using analysis of covariance (ANCOVA). Results: All 64 participants completed the study, with no losses to follow-up. BBS scores increased from 42.6 to 44.4 points in the experimental group and from 42.4 to 43.9 points in the control group. TUG completion time decreased from 15.1 to 14.5 seconds and from 14.9 to 14.4 seconds, respectively. HbA1c decreased from 8.5% to 8.3% in the experimental group and from 8.4% to 8.2% in the control group. Baseline-adjusted comparisons did not demonstrate statistically significant between-group differences in BBS scores (adjusted mean difference = 0.4 points; p = 0.690), TUG completion time (adjusted mean difference = −0.1 seconds; p = 0.860), or HbA1c (adjusted mean difference = −0.1 percentage points; p = 0.620). All experimental-group participants completed the intervention, 90.6% attended at least 80% of sessions, and two participants reported minor exercise-related muscle soreness. Conclusion: Both groups demonstrated improvements in balance, functional mobility, and glycemic control over 12 weeks. However, the study did not demonstrate statistically significant additional benefits of structured physiotherapy over usual diabetes care alone for these outcomes.