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

Background: 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. Objective: To evaluate the effect of a comprehensive rehabilitation on pressure pain threshold(PPT), functional disability, and plantar pressure in T2DM individuals with CLBP. Methods: 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 12^thweek, and the 24^thweek. PPT was evaluated using an algometer. Oswestry disability index(ODI) and Win-Track system were used to assess disability and plantar pressure parameters, respectively. Results: 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. Conclusion: A 12-week comprehensive rehabilitation program was effective in improving PPT, functional disability, and plantar pressure in T2DM individuals with CLBP.