Balance Training and Aerobic Exercise in Diabetic Peripheral Neuropathy: A Systematic Review

Abstract

Background: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus in older adults and is associated with impairments in balance, mobility, and functional capacity that negatively affect quality of life.
Objective: To evaluate the effectiveness of balance training and aerobic exercise on quality of life and related functional outcomes in older adults with diabetic peripheral neuropathy.
Methods: This systematic review followed the PRISMA 2020 guidelines. Literature searches were conducted in PubMed, Google Scholar, SAGE, and ScienceDirect for randomized controlled trials published between 2020 and 2025. Studies involving balance training and/or aerobic exercise in older adults or patients with DPN were included. Methodological quality was assessed using the PEDro scale. Due to heterogeneity across studies, a narrative synthesis was performed.
Results: Seven randomized controlled trials involving 382 participants were included from 993 identified records. Balance training consistently improved postural control, balance stability, and functional mobility, while aerobic exercise demonstrated beneficial effects on glycemic control, cardiovascular capacity, and walking performance. Multimodal interventions combining balance and aerobic exercise produced broader improvements in functional outcomes and quality-of-life domains than single interventions.
Conclusion: Balance training and aerobic exercise are effective in improving functional performance and quality of life in older adults with diabetic peripheral neuropathy and should be considered integral components of rehabilitation programs.