Background: Inadequate blood flow can increase risk of foot ulceration in diabetics. Exercise training can improve lower extremity blood flow in diabetes, however, the intensity of exercise should be taken into account for this population is they are at high risk for developing foot ulcers. Aim: The aim of the present study is to explore the immediate effect of a tailored low impact virtual reality exercise training on lower extremity blood flow in patients with diabetic peripheral neuropathy. We hypothesize that tailored exercise specifically designed for diabetes will induce sufficient muscle activation in order to improve blood flow. Methods: Eight patients (Age: 64.3±10.2 years, BMI 32.6±6.3) with diagnosed DPN (HbA1c: 7.3±1.2) participated in a single 45 minute session for low-impact virtual reality based balance training exercise. Changes in blood flow were quantified by Ankle Brachial Index (ABI) recorded pre- and post-training. Systolic blood pressures were determined at the brachial, posterior tibial, and dorsalis pedis arteries using a 10 MHz handheld Doppler. Results: Non-parametric Wilcoxon Signed Rank test revealed a strong but non-significant reduction in ABI from single session virtual reality training. The values dropped from 1.28 to 1.22 (4.7% reduction, p = 0.173). Conclusion: The initial results show that a tailored low impact exercises for diabetes can improve blood flow, which may reduce the risk for diabetic foot ulceration. Future studies should confirm these findings in a larger pool of patients with 8-12 week exercise training in order to explore the long term effect on exercise on blood flow. Funding Source: QNRF NPRP 4-1025-3-276


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