Effects of Thai Foot Massage on Pain, Ankle Range of Motion and Somatosensory Function in Patients with Type 2 Diabetes Mellitus and Peripheral Neuropathy: A Randomized Controlled Trial

Abstract

Objective: To evaluate the immediate and long-term effects of Thai Foot Massage (TFM) on pain intensity, ankle range of motion (ROM), and somatosensory perception in patients with type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN).
Design: Randomized controlled trial.
Setting: Tehsil Headquarters (THQ) Hospital, Sheikhupura, Pakistan.
Participants: Seventy-two patients with T2DM-associated DPN (aged 45–64 years, diabetes duration >5 years) were randomly allocated using lottery method, to intervention (n=37) and control (n=37) groups.
Intervention: The intervention group received 20-minute TFM sessions on each foot on alternate days for 15 days in addition to routine diabetic care. The control group received routine diabetic care. Blinding was not feasible due to the nature of the intervention.
Main Outcome Measures: Pain intensity measured using the Numeric Pain Rating Scale (NPRS), ankle dorsiflexion and plantarflexion ROM measured with a universal goniometer, and somatosensory perception assessed using the Ipswich Touch Test (IpTT). Outcomes were evaluated at baseline, immediately post-intervention, and at 2- and 4-week follow-up.
Results: Repeated-measures ANOVA demonstrated significant improvements in the intervention group across all outcomes. Pain intensity showed a significant time effect (Pillai’s Trace=0.953, F=249.699, p<0.001), while no significant change was observed in the control group (Pillai’s Trace=0.070, F=1.430, p=0.252). Significant improvements were also observed in right ankle dorsiflexion (Pillai’s Trace=0.764, F=39.983, p<0.001), right plantarflexion (Pillai’s Trace=0.668, F=24.778, p<0.001), left dorsiflexion (Pillai’s Trace=0.803, F=50.262, p<0.001), left plantarflexion (Pillai’s Trace=0.765, F=40.208, p<0.001), and somatosensory perception assessed by IpTT (Pillai’s Trace=0.773, F=42.007, p<0.001). Improvements were maintained at 2- and 4-week follow-up assessments.
Conclusions: Thai Foot Massage produced significant immediate and sustained improvements in pain, ankle mobility, and somatosensory perception in patients with DPN. TFM may be considered a safe and effective complementary intervention to enhance functional outcomes and symptom management in individuals with T2DM-related peripheral neuropathy.
Trial Registration: NCT06066944.
Limitations: The study was conducted at a single center with a relatively short intervention and follow-up period, which may limit generalizability and long-term interpretation of outcomes.