Swing-Phase Plantar Stimulation and Gait Parameters in Patients With Diabetic Neuropathy: A Preliminary Study

Background: Diabetic peripheral neuropathy (DPN) affects nearly 50% of patients with diabetes mellitus, leading to impaired balance and falls. Vibrotactile stimulation during walking is shown to improve gait performance, although the effects of targeted stimulations in the swing phase of gait are unexplored. This study investigated the effects of swing-phase vibrotactile stimulation on gait parameters in DPN. Methods: We conducted a prospective controlled study with the DPN group (DG) aged 18-75 years diagnosed with DPN and the control group (CG) with no diagnosis of diabetes. Participants completed 3-minute walk and Timed Up and Go tests with and without vibrotactile stimulation provided by smart shoes. The shoes measured gait parameters, including stride length, velocity, strike angle, heel clearance, swing-stance ratio, stride duration, and distance. Analysis included the Mann-Whitney U test, with a significance threshold set at P <.05. Results: A total of 28 individuals were analyzed (CG n = 18; DG: n = 10). DG participants were of higher age and BMI compared with controls ( P < .01). At baseline, the DG demonstrated shorter stride length, smaller normalized stride length, lower walking velocity, reduced strike angle, and shorter distance covered in the 3-minute walk ( P < .01). Between-group comparisons revealed increased heel clearance in controls ( P = .03), which was attenuated after adjusting for age and BMI ( P = .17). Conclusion: Our findings did not reveal an immediate effect of swing-phase stimulation on gait parameters in DPN patients. However, temporal gait parameters may require more demanding tasks or longer exposure to yield measurable benefits. Larger, age-matched trials using variability data are warranted to determine efficacy and identify responders in DPN. Level of Evidence: Level II, prospective comparative study.