DPN often leads to balance issues, sensory deficits, and chronic pain, which can severely impact daily functioning and independence. INF therapy aims to improve nerve blood flow and alleviate neuropathic symptoms through manual techniques, while the Otago Exercise Program focuses on enhancing strength and balance to reduce fall risk. By comparing these two interventions, this study seeks to identify effective strategies that can improve balance, reduce pain, and enhance the quality of life for individuals suffering from DPN
Age 50-75years
Both male and female patients will be included in the study
Patient with type 2 diabetes mellitus (diagnosed by the physician)
Patients with a score ≥ 4 on DN4 scale
Patient with presence of any other systemic disease rather than diabetes such as end-stage renal failure, uncontrolled hypertension, severe dyslipidemia, chronic liver disease, autoimmune disease, advanced chronic obstructive pulmonary disease etc
Patients with documented active alcohol or drug misuse
Patient with total or partial amputation of lower extremities
Participants will be also excluded if they were morbidly obese or if pregnant (self-reported)