TY - JOUR
T1 - Using Plantar Electrical Stimulation to Improve Postural Balance and Plantar Sensation among Patients with Diabetic Peripheral Neuropathy
T2 - A Randomized Double Blinded Study
AU - Najafi, Bijan
AU - Talal, Talal K.
AU - Grewal, Gurtej Singh
AU - Menzies, Robert
AU - Armstrong, David G.
AU - Lavery, Lawrence A.
N1 - Publisher Copyright:
© Diabetes Technology Society.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Objective: People with diabetic peripheral neuropathy (DPN) often exhibit deteriorations in motor-performance mainly due to lack of plantar-sensation. The study explored effectiveness of plantar electrical-stimulation therapy to enhance motor-performance among people with DPN. Design and methods: Using a double-blinded model, 28 volunteers with DPN (age: 57.8 ± 10.2 years) were recruited and randomized to either intervention (IG: n = 17) or control (CG: n = 11) group. Both groups received identical plantar-stimulation devices for six weeks of daily use at home; however, only the IG devices were set to deliver stimulation. Balance (ankle, hip, and center of mass [COM] sway) and gait (stride velocity [SV], stride time [ST], stride length [SL], and cadence) were measured using validated wearable sensors. Outcomes were assessed at baseline and at six-week. Clinical assessment including vascular as measured by ankle-brachial-index (ABI) and plantar-sensation as quantified by vibratory plantar threshold (VPT) were also measured at baseline and six weeks. Results: No difference were observed between groups for baseline characteristics (P >.050). Posttherapy, ankle and COM sway with eyes open were significantly improved (P <.05, Cohen's effect size d = 0.67-0.76) in the IG with no noticeable changes in CG. All gait parameters were significantly improved in the IG with highest effect size observed for cadence (d = 1.35, P =.000). Results revealed improvement in VPT (P =.004, d = 1.15) with significant correlation with stride velocity improvement (r =.56, P =.037). ABI was improved in the IG in particulate among those with ABI>1.20 (P =.041, d = 0.99) Conclusion: This study suggests that daily home use of plantar electrical-stimulation may be a practical means to enhance motor-performance and plantar-sensation in people with DPN.
AB - Objective: People with diabetic peripheral neuropathy (DPN) often exhibit deteriorations in motor-performance mainly due to lack of plantar-sensation. The study explored effectiveness of plantar electrical-stimulation therapy to enhance motor-performance among people with DPN. Design and methods: Using a double-blinded model, 28 volunteers with DPN (age: 57.8 ± 10.2 years) were recruited and randomized to either intervention (IG: n = 17) or control (CG: n = 11) group. Both groups received identical plantar-stimulation devices for six weeks of daily use at home; however, only the IG devices were set to deliver stimulation. Balance (ankle, hip, and center of mass [COM] sway) and gait (stride velocity [SV], stride time [ST], stride length [SL], and cadence) were measured using validated wearable sensors. Outcomes were assessed at baseline and at six-week. Clinical assessment including vascular as measured by ankle-brachial-index (ABI) and plantar-sensation as quantified by vibratory plantar threshold (VPT) were also measured at baseline and six weeks. Results: No difference were observed between groups for baseline characteristics (P >.050). Posttherapy, ankle and COM sway with eyes open were significantly improved (P <.05, Cohen's effect size d = 0.67-0.76) in the IG with no noticeable changes in CG. All gait parameters were significantly improved in the IG with highest effect size observed for cadence (d = 1.35, P =.000). Results revealed improvement in VPT (P =.004, d = 1.15) with significant correlation with stride velocity improvement (r =.56, P =.037). ABI was improved in the IG in particulate among those with ABI>1.20 (P =.041, d = 0.99) Conclusion: This study suggests that daily home use of plantar electrical-stimulation may be a practical means to enhance motor-performance and plantar-sensation in people with DPN.
KW - balance
KW - diabetes
KW - electrical stimulation
KW - gait
KW - intervention
KW - peripheral neuropathy
KW - skin perfusion
KW - wearable
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U2 - 10.1177/1932296817695338
DO - 10.1177/1932296817695338
M3 - Article
C2 - 28627217
AN - SCOPUS:85023192964
SN - 1932-2968
VL - 11
SP - 693
EP - 701
JO - Journal of Diabetes Science and Technology
JF - Journal of Diabetes Science and Technology
IS - 4
ER -