OBJECTIVE: To investigate the effect of combination therapy of backward-walking training plus alpha-lipoic acid (ALA) treatment on the distribution of plantar pressure of the patients with diabetic peripheral neuropathy (DPN). DESIGN: The test group was treated with combination therapy of backward walking exercise plus ALA, in which lipoic acid for 2 weeks and backward walking exercise for 12 weeks, and the control group only received lipoic acid treatment. Plantar pressure before and after the treatment was tested and analyzed with the flatbed plantar pressure measurement system Footscan. SETTING: This study was carried out in a clinical and laboratory setting. PARTICIPANTS: Sixty patients with DPN were divided into test group (n = 30), and control group (n = 30). INTERVENTIONS: The test group was delivered with physical medicine plus pharmacotherapy interventions, ie, backward walking exercise with ALA treatment the control group only received lipoic acid treatment. MAIN OUTCOME MEASURES: Plantar pressure before and after the treatment was tested and analyzed with the flatbed plantar pressure measurement system Footscan. RESULTS: After the treatment, the peak plantar pressure in the forefoot has dropped for both the test group and the control group, and the same dropped significantly for the test group, and the peak plantar pressure in the medial-foot has slightly increased for the test group, suggesting a more even distribution of plantar pressure in the test group after the treatment. CONCLUSION: The combination therapy of ALA plus backward walking has proved to be more effective than ALA monotherapy. Backward walking also has an ameliorating effect on the balance ability and muscle strength of DPN patients.

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