Effect of TENS and Exercise on Balance and Strength in Diabetic Neuropathy: A Case Report

Abstract

Background: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus characterized by sensory impairment, neuropathic pain, muscle weakness, and balance dysfunction, which collectively increase the risk of functional limitations and falls.

Objective: To describe the clinical outcomes of a combined Transcutaneous Electrical Nerve Stimulation (TENS) and exercise intervention on pain, balance, and muscle strength in a patient with DPN.

Methods: This case report describes one female patient (n = 1), aged 59 years, diagnosed with DPN who received physiotherapy intervention for three weeks (two sessions per week). The intervention consisted of TENS and lower-extremity strengthening exercises based on the FITT principle. Outcome measures included pain intensity using the Numeric Rating Scale (NRS), muscle strength using Manual Muscle Testing (MMT), and functional mobility using the Timed Up and Go Test (TUG).

Results: After three weeks of intervention, pain intensity decreased from 6/10 to 4/10 for tenderness and from 5/10 to 3/10 for movement pain (Δ = −2). Muscle strength improved from 3/5 to 4/5 in both knee and ankle muscle groups. Functional mobility also improved, as indicated by a reduction in TUG time from 20 seconds to 16 seconds (Δ = −4 seconds), suggesting enhanced balance and mobility.

Conclusion: A combined TENS and exercise intervention may contribute to improvements in pain, muscle strength, and functional mobility in patients with DPN. These findings suggest that a combined TENS and exercise approach may support short-term improvements in functional mobility and pain management in clinical practice, although further evidence is required.