# Effect of comprehensive rehabilitation on pressure pain threshold, functional disability, and plantar pressure among type 2 diabetes mellitus individuals with chronic low back pain

## TL;DR

A 12-week rehabilitation program improved pain sensitivity, disability, and foot pressure in people with type 2 diabetes and chronic low back pain.

## Contribution

This study demonstrates the effectiveness of a combined rehabilitation approach for T2DM patients with CLBP.

## Key findings

- Pain threshold and functional disability significantly improved after 12 weeks of rehabilitation.
- Maximal and average plantar pressure also showed significant improvement.
- Contact area of feet remained unchanged over time.

## Abstract

Chronic low back pain(CLBP) is the most prevalent musculoskeletal problem reported by individuals with Type 2 Diabetes Mellitus(T2DM). The effect of therapeutic intervention in this concomitant group of conditions has received limited scholarly attention.

To evaluate the effect of a comprehensive rehabilitation on pressure pain threshold(PPT), functional disability, and plantar pressure in T2DM individuals with CLBP.

In this study, 40 T2DM individuals with CLBP were included based on the pre-decided eligibility criteria. These participants received a comprehensive rehabilitation consisting of photobiomodulation, pain education, and exercise interventions for 12 weeks. The intervention's effect was evaluated on PPT, disability, and plantar pressure, which were assessed at baseline, the 12th week, and the 24th week. PPT was evaluated using an algometer. Oswestry disability index(ODI) and Win-Track system were used to assess disability and plantar pressure parameters, respectively.

A statistically significant improvement over the time points was noted in PPT (F(1.72,67.07) = 117.9), ODI (F(1.49,58.19) = 119), maximal plantar pressure (F(1.62,63.09) = 33.01), and average plantar pressure (F(1.41,55.11) = 19.87). No significant difference was observed in contact area of bilateral feet across different timepoints.

A 12-week comprehensive rehabilitation program was effective in improving PPT, functional disability, and plantar pressure in T2DM individuals with CLBP.