Peripheral neuropathy remains a common complication of diabetes, often associated with pain, impaired nerve conduction, and altered muscle function. A controlled interventional study published in Clinical Diabetology evaluated whether adding neural mobilization to resistance exercise influences neuropathy symptoms, neurophysiology, and muscle function in patients with diabetic peripheral neuropathy (DPN).

Thirty-three patients with DPN were recruited and equally assigned to three groups: neural mobilization combined with resistance exercise (NME), resistance exercise alone (EX), or a control group receiving no exercise intervention. The intervention period lasted eight weeks, with the exercise protocols conducted three days per week. Outcomes assessed at baseline and after eight weeks included pain, fasting glucose, glycated hemoglobin (HbA1c), nerve conduction velocity (NCV) of the tibial, peroneal, and sural nerves, and muscle activity parameters including average maximum voluntary isometric contraction (averageMVIC), percentage MVIC (%MVIC), and the co-contraction index (CCI).

Baseline comparisons showed no significant differences among groups except for the numerical pain rating scale and peroneal nerve conduction velocity. During follow-up, tibial and sural nerve conduction velocities demonstrated significant time effects (p < 0.001 and p < 0.05), group effects (p < 0.001 and p<0.05), and time × group interaction effects (p < 0.001 and p < 0.05). The average MVIC of the tibialis anterior showed a significant time effect (p < 0.01) and time × group interaction (p < 0.05), while the co-contraction index improved significantly over time (p < 0.05) and between groups (p < 0.01).

The findings indicate that neural mobilization used alongside resistance exercise was associated with improvements in nerve conduction velocity among patients with moderate diabetic peripheral neuropathy over the eight-week intervention period.