Effect of Home-Based Exercise on Functional Performance and Risk of Fall in Diabetic Neuropathy Patients

Objectives Diabetic neuropathy (DN) significantly impairs mobility and increases fall risk. While supervised exercise benefits are well documented, home-based protocols aligned with international guidelines and targeting functional outcomes remain underexplored, particularly in rural settings. Material and Methods This study aimed to evaluate the effectiveness of a structured, evidence-based, home exercise protocol on functional performance and fall risk in participants with diabetic peripheral neuropathy (DPN) living in rural India. A total of 56 participants with DPN (mean age 57.4 ± 12.6 years, mean Michigan diabetic neuropathy score (MDNS) 9.29) performed a 4-week structured home exercise program targeting lower extremity strength, balance, and gait. Functional performance was assessed using the short physical performance battery (SPPB) and fall risk using the dynamic gait index (DGI). Glycaemic parameters (Fasting blood sugar [FBS], postprandial blood sugar [PPBS], and glycated haemoglobin [HbA1C]) were also analysed. Results The data were analysed using Systat Sigma Plot software. A p ≤0.05 was considered statistically significant. Significant post-intervention improvements were observed in SPPB by 2.04 points and DGI by 3.37 points ( p <0.001). These improvements were accompanied by significant reductions in FBS and PPBS - FBS: 167.98 ± 42.77 to 144.55 ± 30.46 mg/dL; PPBS: 253.30 ± 54.48 to 202.20 ± 37.97 mg/dL. Significant improvements were observed, particularly a shift from high-risk to moderate fall risk category. Conclusion This prospective interventional study demonstrates that a structured, home-based exercise protocol can meaningfully improve functional performance and reduce fall risk in participants with DPN. Its feasibility and impact in a rural Indian cohort underscore its potential for scalable implementation in low-resource settings.