Apr 19, 2026
Version 2
Effect of Stretching (FNS) and Strengthening Exercise (WBE) for Diabetic Neuropathy V.2
- MEHEDI HASAN BADSHA1,
- Dr. Md. Feroz Kabir1,
- K M Amran Hossain1
- 1Department of Physiotherapy & Rehabilitation, Jashore University of Science & Technology
Protocol Citation: MEHEDI HASAN BADSHA, Dr. Md. Feroz Kabir, K M Amran Hossain 2026. Effect of Stretching (FNS) and Strengthening Exercise (WBE) for Diabetic Neuropathy. protocols.io https://dx.doi.org/10.17504/protocols.io.n2bvjernpgk5/v2Version created by MEHEDI HASAN BADSHA
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: March 02, 2026
Last Modified: April 19, 2026
Protocol Integer ID: 244299
Keywords: Diabetic Neuropathy, Functional Neural Stretching, Weight-Bearing Exercise, Physiotherapy., exercises into diabetic neuropathy rehabilitation protocol, diabetic neuropathy rehabilitation protocol, diabetic neuropathy, effectiveness of functional neural stretching, receiving neural stretching, neural stretching, functional neural stretching, strengthening exercise, significant improvements in pain relief, physiotherapy, stretching, structured physiotherapy protocol, standard physiotherapy, rehabilitation, neuropathy symptom, based exercise, pain relief, including pain, diabetic neuropathy type, effect of stretching, exercise versus standard care, neuropathy symptoms as primary outcome, diabetes mellitus, ankle range of motion, diabetes, department of physiotherapy, measuring pain intensity, muscle strength, pain intensity, ankle range
Funders Acknowledgements:
Department of Physiotherapy & Rehabilitation, Jashore University of Science & Technology
Abstract
Type 2 diabetes mellitus is increasing globally and diabetic neuropathy substantially impairs quality of life and functional mobility. Effective non-invasive treatments remain limited, particularly in resource-constrained settings. This randomized controlled trial will evaluate the effectiveness of functional neural stretching and weight-bearing exercise versus standard care in individuals with diabetic neuropathy. A total of 84 participants aged 40–80 years with type 2 diabetes and diabetic neuropathy of at least 1 year’s duration will be recruited from three centers in Dhaka and Jashore and randomly allocated to experimental or control groups (n=42 each). The intervention will last 8 weeks, with assessments at baseline, post-intervention, and 24-week follow-up, measuring pain intensity and neuropathy symptoms as primary outcomes, and ankle range of motion, functional mobility, muscle strength, and quality of life as secondary outcomes. The trial has received ethical approval from the Institutional Review Board of the Department of Physiotherapy & Rehabilitation, Jashore University of Science & Technology (PTR-JUST/IRB/2025/04/08).
Guidelines
1. Pre-session Patient Assessment
2. Glycemic Safety Monitoring
3. Warm-up Standardization
4. Neural Mobilization Technique Control
5. Weight-Bearing Exercise Progression
6. Foot Protection and Sensory Care
7. Fatigue and Overload Management
8. Post-session Cool-down and Monitoring
Materials
Primary Outcome Tools:
• Pain: Visual Analog Scale (VAS)
• Neuropathy Symptoms: Michigan Neuropathy Screening Instrument (MNSI)
Secondary Outcome Tools:
• Ankle ROM: Goniometer
• Mobility: Timed Up and Go (TUG) Test
• Strength: Manual Muscle Testing (MMT),
WHOQOL:
• World Health Organization Quality of Life assessment.
Safety warnings
During treatment, exercises must be performed within a pain-free range with careful monitoring of blood glucose, fatigue, and balance. Therapy should be stopped immediately if the patient develops dizziness, excessive pain, or hypoglycemic symptoms. Extra caution is required for foot protection to prevent injury due to reduced sensation. Avoid overexertion by progressing gradually, and ensure all sessions are supervised with prompt adjustment if any adverse effects occur.
Ethics statement
This study has received ethical approval from the Institutional Review Board (IRB) of Jashore University of Science and Technology, Bangladesh (Approval No: PTR-JUST/IRB/2025/04/08). All procedures involving human participants will be conducted in accordance with the Declaration of Helsinki and other internationally accepted ethical standards. Prior to participation, written informed consent will be obtained from all subjects. No part of the study will begin without prior IRB approval.
Protocol references
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Espinoza R, et al. Prevalence and incidence of diabetic peripheral neuropathy in Latin America and the Caribbean: A systematic review and meta-analysis. Negida A, editor. PLOS ONE. 2021 May 13;16(5):e0251642.
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Acknowledgements
We would like to express our sincere gratitude to the Department of Physiotherapy and Rehabilitation at Jashore University of Science and Technology (JUST) for partially funding this study. We also thank the faculty members, clinical staff, and all participants whose support and cooperation were essential to the successful execution of this research.