Comparative effects of walking meditation and massage on foot peripheral blood flow in persons with TYPE-2 diabetic peripheral neuropathy: A randomized controlled trial

Background Type-2 diabetic peripheral neuropathy (type-2 DPN) combined with impaired peripheral blood flow (PBF) elevates foot ulcer/amputation risk. Massage and walking meditation (WM) were claimed to improve PBF. However, the comparative effects of these interventions on foot PBF in type-2 DPN remain unclear. Objective To compare effects of WM and self-massage on foot PBF via dorsalis pedis arteries (DPa) and posterior tibial arteries (PTa) in persons with type-2 DPN. Methods Twenty-six participants with type-2 DPN were randomly assigned into 3 groups; WM group (WMG, n=8), massage group (MG, n=9) and control group (CG, n=9). WMG and MG attended their respective programs for 4 weeks (30 minutes/day, 3 days/week), while CG received only muscle stretching same as warm-up/cool-down sessions of those programs. PBF in DPa and PTa were measured at baseline and post-training using doppler ultrasound. Data were analyzed using Wilcoxon signed-rank tests for intragroup comparisons and Kruskal-Wallis tests with post-hoc Mann-Whitney U tests for intergroup differences. Results Intragroup analysis showed significant PBF increases in PTa for the WMG, and in both DPa and PTa for the MG; no changes were observed in the CG. While baseline PBF was comparable across all groups, both intervention groups (WMG and MG) achieved significantly higher post-training PBF than the CG (p < 0.05). No significant differences were found between the WMG and MG. Conclusion Both WM and self-massage improved foot PBF in participants with type-2 DPN compared to stretching alone. Therefore, WM and self-massage can be recommended for enhancing foot PBF in type-2 DPN.